Embedded Files
patients who were extubated in PACU between March 1 and March 18 in 2020 were identified, of which, 9 were excluded for lacking arterial blood gas data for the study period, 5 for the duration of surgery over 3 hours, and 1 for hypoxemia before surgery. The rest 136 patients were assigned to Group B. In addition, 160 patients who were extubated in PACU between January 1 and January 27 in 2020 were also identified, of which, 11 patients were excluded for lacking arterial blood gas data, 7 for the duration of surgery over 3 hours, 4 for preoperative hypoxemia, and 1 for aging 17. The rest 136 patients were assigned to Group A (Fig. 2). In total, 273 patients were selected in this study, including 137 patients (aged from 20 to 87) without masks (Group A) and 136 patients (aged from 18 to 91) with masks (Group B). No patients were confirmed with COVID-19 by RT-PCR and chest CT scans before surgery, with no statistically significant in age, BMI, smoking status, history of chronic obstructive pulmonary disease (COPD), ASA classification, type of surgery, which might be the risks of postoperative hypoxemia in PACU between the two groups19, 28, 29 (Table 1). 12 Primary outcome There was no significant difference in SpO2 between two groups, (100[99-100] and 99[98-100] , inhaling 40% O2 in 10L min-1 ) (P=0.213) and (98[97-99] and 98[97-99], taking in the air) (P=0.923), respectively (Table 2). No patient had hypoxemia (SpO2＜90%) in two groups. And there were 13(9.5%) in Group A and 14(10.3%) in Group B with SpO2＜95% (P=0.824) after taking in the air. Secondary outcomes There was no patient with PaO2/FiO2＜150mmHg in two groups. Patients with PaO2/FiO2＜ 300mmHg in two groups were 10(7.3%) and 11(8.1%) ( P=0.807), respectively. PaCO2＞ 45mmHg were 29(21.2%) in Group A and 31(22.8% ) in Group B( P=0.746) (Table 3). No significant differences were found in heart rate, noninvasive mean blood pressure between oxygen group and non-oxygen group ( P＞0.05) (Table 2). The median duration after extubation in PACU was shorter (50[45-55]) in Group B than (54[48-60]) Group A (P＜0.001). There was no significant difference in postoperative complications between the two groups (Table 3). Patient comfort are depicted in Table 3. Compared with Group A, wearing masks was associated with a lower comfort (6[4-7] vs.7[6-8] ) ( P＜0.001). All patients, anaesthesiologists and nurses in this study had no cough, sore throat, myalgia, shortness of breath and gastrointestinal reaction in the hospital. Discussion 13 This is the first retrospective report to explore the impact of wearing medical masks on oxygen saturation in adult surgical patients undergoing general anaesthesia during the COVID-19 epidemic. Compared with patients wearing medical masks or not in PACU after extubation, we did not find a reduction in oxygen saturation in adult patients with or without medical masks after extubation. Nevertheless, wearing medical masks may reduce the patient’s comfort in PACU. Arterial blood gas data including PaO2, PaO2/FiO2 and PaCO2 were not affected by wearing medical masks or not, with no adverse effects in hemodynamics and complication after extubation. It is recommended that patients with COVID-19 should be sent to an isolation room in the ICU after surgery or be extubated in the operating room, bypassing the PACU.17 With the control of COVID-19, an increasing number of surgical patients with a negative history of epidemiology, RT-PCR, and chest CT scan will either be in low-risk infected areas or undergo surgery and recover in PACU.30 However, to avoid nosocomial transmission of the virus, the medical and nursing staff should always use PPE, and the patients should wear masks during the entire stay. In spite of this, all the PACU staff have to comply with infection control measures, including hand cleansing and changing gloves in time. To shorten the length of stay in PACU during the COVID-19 epidemic, we transferred the patients to ward when they met the standards for leaving PACU. During the COVID-19 pandemic, health-care workers and the general public are
Report abuse