INCIDENCE OF POSTOPERATIVE HYPOXIA IN CHILDREN FOLLOWING GENERAL ANESTHESIA FOR SURGICAL PROCEDURES: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.71000/nvceeh21Keywords:
Hypoxia, Hypoxemia, Oxygen saturation, Anesthesia, General, Pediatrics, Oxygen Inhalation Therapy, Postoperative ComplicationsAbstract
Background: Hypoxemia represents one of the most serious perioperative complications and is commonly encountered during intraoperative, postoperative, and recovery phases. Children are at particular risk due to reduced functional residual capacity, higher oxygen consumption, and immature airway structures. Despite advances in perioperative monitoring and anesthesia techniques, postoperative hypoxia remains frequent, even following minor procedures. Recognizing its burden and associated risk factors is essential for developing effective monitoring and preventive strategies to improve pediatric surgical outcomes.
Objective: The objective of this review was to determine the incidence of postoperative hypoxia in pediatric patients undergoing surgery under general anesthesia and to identify associated risk factors.
Methods: A systematic review was conducted by searching electronic databases including PubMed, Embase, MEDLINE, Cochrane Library, JAMA Network, Google Scholar, and ScienceDirect. Articles published from 2012 onwards were screened using keywords such as hypoxemia, postoperative hypoxia, pediatric anesthesia, oxygen saturation, and recovery period. Of 62 initially identified studies, 50 met the inclusion criteria, and 25 were selected for final analysis. Clinical trials, observational studies, and reviews involving children undergoing surgery under general anesthesia were included, while case reports, editorials, and pre-2012 publications were excluded.
Results: Analysis of included studies demonstrated that body weight, gender, and duration of surgery had no significant effect on the incidence of postoperative hypoxia. In contrast, age was a major determinant, with younger children experiencing higher rates of desaturation. One study reported 20% mild hypoxemia (SaO₂ 86–90%), 2.66% moderate (81–85%), and 1.33% extreme (<76%) in patients without supplemental oxygen. Another study found desaturation in 21% of children transported under room air compared with only 3% in those given oxygen supplementation. Postoperative hypoxemia was most common in infants under six months and in children with pneumonia, where rates reached 42.7%.
Conclusion: Postoperative hypoxemia is a prevalent complication in pediatric patients, particularly in infants and those with comorbidities. Continuous pulse oximetry and provision of supplemental oxygen during transfer and recovery are essential preventive measures to reduce adverse outcomes.
Background: Hypoxemia represents one of the most serious perioperative complications and is commonly encountered during intraoperative, postoperative, and recovery phases. Children are at particular risk due to reduced functional residual capacity, higher oxygen consumption, and immature airway structures. Despite advances in perioperative monitoring and anesthesia techniques, postoperative hypoxia remains frequent, even following minor procedures. Recognizing its burden and associated risk factors is essential for developing effective monitoring and preventive strategies to improve pediatric surgical outcomes.
Objective: The objective of this review was to determine the incidence of postoperative hypoxia in pediatric patients undergoing surgery under general anesthesia and to identify associated risk factors.
Methods: A systematic review was conducted by searching electronic databases including PubMed, Embase, MEDLINE, Cochrane Library, JAMA Network, Google Scholar, and ScienceDirect. Articles published from 2012 onwards were screened using keywords such as hypoxemia, postoperative hypoxia, pediatric anesthesia, oxygen saturation, and recovery period. Of 62 initially identified studies, 50 met the inclusion criteria, and 25 were selected for final analysis. Clinical trials, observational studies, and reviews involving children undergoing surgery under general anesthesia were included, while case reports, editorials, and pre-2012 publications were excluded.
Results: Analysis of included studies demonstrated that body weight, gender, and duration of surgery had no significant effect on the incidence of postoperative hypoxia. In contrast, age was a major determinant, with younger children experiencing higher rates of desaturation. One study reported 20% mild hypoxemia (SaO₂ 86–90%), 2.66% moderate (81–85%), and 1.33% extreme (<76%) in patients without supplemental oxygen. Another study found desaturation in 21% of children transported under room air compared with only 3% in those given oxygen supplementation. Postoperative hypoxemia was most common in infants under six months and in children with pneumonia, where rates reached 42.7%.
Conclusion: Postoperative hypoxemia is a prevalent complication in pediatric patients, particularly in infants and those with comorbidities. Continuous pulse oximetry and provision of supplemental oxygen during transfer and recovery are essential preventive measures to reduce adverse outcomes.
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Copyright (c) 2025 Shahid Hussain, Sajid Iqbal, Jawad Ahmad Khan, Hikmat Yar, Ahmad Ullah Khan, Niaz Ali (Author)
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