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| Related factors and the nursing strategies of the hypoxemia during anesthesia recovery period of patients after laparoscopic total hysterectomy under general anesthesia |
| People's Hospital of Xinjiang Uygur Autonomous Region（Xinjiang Clinical Research Center for Anesthesia Management）, Urumqi, Xinjiang Uygur Autonomous Region, 830001 |
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Abstract To investigate the related factors of the hypoxemia during anesthesia recovery period of patients after laparoscopic total hysterectomy (LTH) under general anesthesia, and to provide the nursing countermeasures of the hypoxemia. Methods: The clinical data of 280 patients with LTH under general anesthesia in hospital from March 2022 to January 2024 were analyzed retrospectively. Logistic regression was used to analyze the influencing factors of the hypoxemia of the patients with LTH during the anesthesia recovery. The regression prediction model was constructed, and the goodness of fit and the predictive efficiency of the model for the hypoxemia of the patients with LTH during the anesthesia recovery was determined. Results: The incidence of the hypoxemia of the patients with LTH during anesthesia recovery was 27.1% (76/280). Univariate analysis showed that there were significant differences in the age, the body mass index (BMI), the classification by American society of anesthesiologists (ASA) rating, the dosage of propofol used, the operation time, and the duration of the postanesthesia care unit (PACU) stay between the patients with hypoxemia and the patients without hypoxemia (P<0.05). Binary logistic regression analysis showed that the age ≥65 years old (OR=1.926, 95%CI 1.073-3.458), the high BMI (OR=1.824, 95%CI 1.485-2.239), the gradeⅢ of ASA (OR=2.353, 95%CI 1.0733.458), the high dosage of propofol used (OR=1.005, 95%CI 1.002-1.008) and the long operation time (OR=1.078, 95%CI 1.050-1.107) of the patients with LTH were the factors influencing their hypoxemia during the anesthesia recovery period (P<0.05). According to these influencing factors, the prediction model was constructed, and the H-L test prediction model had a good goodness of fit. Receiver operating characteristic (ROC) curve showed that the area under the curve, the sensitivity and the specificity of the model for predicting the hypoxemia of the patients with LTH during the anesthesia recovery period were 0.900, 80.3% and 87.3%, respectively. Conclusion: The age ≥65 years old, the high BMI, the grade Ⅲ of ASA, the high dosage of propofol used, and the long operation time of the patients with LTH during the anesthesia recovery period can affect their hypoxemia occurrence, and the prediction model established based on these affecting factors has the good predictive effect for the hypoxemia occurrence of the patients. The clinical prevention and nursing based on the prediction model should be conducted, so as to reduce the risk of the hypoxemia of the patients with LTH during the anesthesia recovery period.
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