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Gali B, Gritzner SR, Henderson AJ, et al. Respiratory Depression Following Ambulatory Urogynecologic Procedures: A Retrospective Analysis. Mayo Clin Proc Innov Qual Outcomes. 2019;3(2):169-175doi: 10.1016/j.mayocpiqo.2019.02.002.
Gali, B., Gritzner, S. R., Henderson, A. J., Warner, M. E., Sibanda, S. L., Sprung, J., & Weingarten, T. N. (2019). Respiratory Depression Following Ambulatory Urogynecologic Procedures: A Retrospective Analysis. Mayo Clinic proceedings. Innovations, quality & outcomes, 3(2), 169-175. https://doi.org/10.1016/j.mayocpiqo.2019.02.002
Gali, Bhargavi, et al. "Respiratory Depression Following Ambulatory Urogynecologic Procedures: A Retrospective Analysis." Mayo Clinic proceedings. Innovations, quality & outcomes vol. 3,2 (2019): 169-175. doi: https://doi.org/10.1016/j.mayocpiqo.2019.02.002
Gali B, Gritzner SR, Henderson AJ, Warner ME, Sibanda SL, Sprung J, Weingarten TN. Respiratory Depression Following Ambulatory Urogynecologic Procedures: A Retrospective Analysis. Mayo Clin Proc Innov Qual Outcomes. 2019 May 27;3(2):169-175. doi: 10.1016/j.mayocpiqo.2019.02.002. eCollection 2019 Jun. PMID: 31193899; PMCID: PMC6543496.
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Mayo Clin Proc Innov Qual Outcomes. 2019 May 27;3(2):169-175. doi: 10.1016/j.mayocpiqo.2019.02.002. eCollection 2019 Jun.

Respiratory Depression Following Ambulatory Urogynecologic Procedures: A Retrospective Analysis.

Mayo Clinic proceedings. Innovations, quality & outcomes

Bhargavi Gali, Sarah R Gritzner, Amy J Henderson, Mary E Warner, Sinokuthaba L Sibanda, Juraj Sprung, Toby N Weingarten

Affiliations

  1. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN.
  2. Department of Nursing, Mayo Clinic College of Medicine and Science, Rochester, MN.
  3. Mayo Clinic School of Health Sciences, Mayo Clinic, Rochester, MN.

PMID: 31193899 PMCID: PMC6543496 DOI: 10.1016/j.mayocpiqo.2019.02.002

Abstract

OBJECTIVE: To assess the rate of postanesthesia respiratory depression (RD) and test for potential associations with clinical characteristics of patients undergoing urogynecologic procedures at ambulatory surgical centers (ASCs). Postanesthesia RD is poorly characterized for patients undergoing urogynecologic procedures in ASCs.

PATIENTS AND METHODS: Health records of adult patients undergoing urogynecologic procedures at an ASC from July 1, 2010, through December 31, 2015, were abstracted. Cases complicated by RD were identified, and analyses of risk factors were performed with generalized estimating equations (GEE).

RESULTS: During the study time frame, 9105 patients underwent 9141 procedures, of which RD complicated 221 cases (mean [95% confidence interval (CI)] complication rate per 100 cases, 2.4 [2.1-2.8]). Risk increased with advancing age, male sex, obstructive sleep apnea (OSA), morbid obesity, and use of volatile anesthetics and airway secured. Patients with RD had longer anesthesia recovery (median [interquartile range], 135 [110-166] vs 105 [80-138] minutes;

CONCLUSION: Postanesthesia RD after ambulatory urogynecologic procedures delay anesthesia recovery but are not associated with later complications. Patients with OSA or having other conditions related to OSA, or both, are at higher risk for RD.

Keywords: ASC, ambulatory surgical center; BMI, body mass index; CPAP, continuous positive airway pressure; IQR, interquartile range; OR, odds ratio; OSA, obstructive sleep apnea; PACU, postanesthesia care unit; RD, respiratory depression; SpO2, oxygen saturation as measured by pulse oximetry

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