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Canadian Journal of Anesthesia, Vol 33, 745-753, Copyright © 1986 by Canadian Anesthesiologists' Society

Perioperative Transcutaneous Oxygen Monitoring in Thoracic Anaesthesia

NORMANDIE M. CHUBRA-SMITH MD FRCPC1, RAYMER P. GRANT MD FRCPC1, and LEONARD C. JENKINS MD FRCPC1

1 Department of Anaesthesiology, The University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia

Address correspondence to: Dr. N.M. Chubra-Smith, Department of Anaesthesia, Burnaby General Hospital, 3935 Kincaid Street, Burnaby, British Columbia, Canada V5G 2X6.

Transcutaneous oxygen tension (PtcO2) was measured in 30 patients scheduled for elective pulmonary resection requiring one-lung ventilation during anaesthesia. Simultaneous PtcO2 and arterial oxygen tension (PaO2) measurements were taken preoperatively (preop), intraoperatively during two-lung endotracheal (ET) and one-lung endobronchial ventilation (EB), and postoperatively (postop). There was a significant correlation (r) between PtcO2 and PaO2 at all time periods: 0.97 (preop); 0.91 (ET); 0.83 (EB); 0.81 (postop). There were no significant differences among the transcutaneous oxygen indices (tcO2 index = PtcO2/PaO2) in the preop (0.69 ± 0.09), ET(0.68 ± 0.10) and postop (0.71 ± 0.12) time period. The tcO2 index was significantly lower during one-lung anaesthesia (0.61 ± 0.14). The PtcO2 was consistently lower than the corresponding PaO2 measurement, thus providing a continuous estimation of the "minimum" PaO2 level throughout anaesthesia and recovery. In four patients a marked drop in PtcO2 occurred just after the initiation of one-lung ventilation. In three, this was associated with arterial hypoxaemia and in one, haemodynamic compromise. In all four cases the PtcO2 was the first monitored parameter to change. As there is a substantial risk of developing hypoxaemia during thoracic anaesthesia, PtcO2 monitoring provides valuable early warning of impending hypoxaemia or haemodynamic compromise, thereby facilitating early therapeutic intervention.

Key Words: ANAESTHETIC TECHNIQUES: one-lung, endobronchial • MEASUREMENT TECHNIQUES: transcutaneous PO2 • MONITORING: oxygen • OXYGEN: hypoxia, tension






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Copyright © 1986 by the Canadian Anesthesiologists' Society.