Enhancing Perioperative Oxygenation and Apnea Management: Physiological Foundations, Clinical Benefits, and Potential Concerns

Abstract

Introduction: Preoxygenation is a widely accepted anesthesia technique, aimed at increasing oxygen reserves to delay arterial hemoglobin desaturation during apnea. This study explores the physiological, clinical, and potential aspects of preoxygenation, assessing its efficacy and efficiency. Various techniques have been introduced to enhance preoxygenation, highlighting its relevance in managing surgical apnea. Objective: To examine and discuss the physiological basis, clinical benefits, and potential concerns of preoxygenation in perioperative care, providing insights into its significance in managing surgical apnea. Methodology: A single-blind cross-sectional study involving 500 participants was conducted in Lady Reading Hospital, Peshawar, from September 2022 to February 2023. Demographic characteristics, including age, gender, education, employment status, duration of urban residence, and access to green spaces, were recorded. Participants reported their mental health, stress or anxiety symptoms, relaxation frequency in green spaces, and smoking status. Statistical analyses included chi-square tests, correlation analyses, and one-way ANOVA.  Results: The preoxygenation group exhibited diverse age representation, with a notable proportion (44%) falling within the 18-35 age range. Gender distribution was balanced, including diverse gender identities. Educational backgrounds spanned from secondary education to postgraduation, reflecting a broad spectrum. The majority (80%) were employed full-time, highlighting socioeconomic diversity. Access to urban green spaces (72%) was prevalent, with varying visit frequencies and activities. Mental health perceptions and stress/anxiety symptoms varied among participants. The chi-square test indicated no significant association between asthma prevalence and gender. A correlation analysis revealed a weak and non-significant correlation between age and asthma prevalence. Smoking status demonstrated a statistically significant effect on apnea prevalence. Conclusion: The study highlights preoxygenation's clinical significance in enhancing patient safety by reducing hypoxemia incidence, shortening mechanical ventilation duration, and decreasing PACU stay. These aligned outcomes strengthen the evidence for preoxygenation's adoption as routine in surgery. Overall, preoxygenation proves to be a straightforward, risk-reducing, highly effective intervention with potential cost savings, advocating its imperative inclusion as a standard practice in all surgical settings.