Research progress on hypoxemia during the recovery period after general anesthesia in tumor patients_West China Medical Journal

Authors：

ZHOU Xin ^1,2 ,  LI Ka ¹

1. West China School of Nursing, Sichuan University / West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Anesthesia and Surgery Center, West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan 610213, P. R. China;

Corresponding?author：

LI Ka, Email: lika127@126.com

Keywords：

Tumor; hypoxemia; recovery period; risk factor; intervention

DOI：

10.7507/1002-0179.202503029

Video：

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Abstract Full text Figures/Tables Video References Cited by

The incidence of hypoxemia during the recovery period after general anesthesia in tumor patients is relatively high, which seriously affects the patient’s prognosis. This article reviews the risk factors for hypoxemia in tumor patients during the recovery period after general anesthesia, including individual patient factors, anesthesia factors, and surgical factors. It also summarizes the prevention and intervention measures before, during, and after surgery. At present, there is no unified evaluation standard and intervention plan for risk factors. In the future, evaluation standards and anesthesia nursing intervention plans for hypoxemia risk factors in tumor surgery patients should be established to provide references for clinical application.

Citation： ZHOU Xin, LI Ka. Research progress on hypoxemia during the recovery period after general anesthesia in tumor patients. West China Medical Journal, 2026, 41(3): 520-523. doi: 10.7507/1002-0179.202503029 Copy

1.	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2.	鄭榮壽, 陳茹, 韓冰峰, 等. 2022 年中國惡性腫瘤流行情況分析. 中華腫瘤雜志, 2024, 46(3): 221-231.
3.	Guo R, Yang WW, Zhong ML, et al. The relationship between anesthesia, surgery and postoperative immune function in cancer patients: a review. Front Immunol, 2024, 15: 1441020.
4.	Rudy M, Saller T. Postoperatives delir im aufwachraum. Anaesthesiologie, 2023, 72(7): 459-466.
5.	中華醫學會麻醉學分會. 麻醉后監測治療專家共識. 臨床麻醉學雜志, 2021, 37(1): 89-94.
6.	Li H, Zhang Y, Cai J, et al. Risk factors of hypoxemia in the postanesthesia care unit after general anesthesia in children. J Perianesth Nurs, 2023, 38(5): 799-803.
7.	魏時靖, 王強, 劉思晗, 等. 腫瘤病人全身麻醉蘇醒期低氧血癥發生次數的影響因素. 護理研究, 2024, 38(6): 1053-1057.
8.	Payne JP, Conway CM. Hypoxaemia after surgery and anaesthesia. Postgrad Med J, 1966, 42(488): 341-350.
9.	Blair I, Holland R, Lau W, et al. Oxygen saturation during transfer from operating room to recovery after anaesthesia. Anesth Intensive Care, 1987, 15(2): 147-150.
10.	屠海林, 孫建良, 陸雅萍, 等. 全麻蘇醒期嚴重低氧血癥的原因與處理. 現代實用醫學, 2005, 17(8): 514-515.
11.	Dylczyk-Sommer A, Sawicka W, Wujtewicz M. The incidence of postoperative hypoxaemia during transportation to the recovery area. Anestezjol Intens Ter, 2011, 43(2): 68-70.
12.	Liu K, Scott JB, Jing G, et al. Management of postoperative hypoxemia. Respir Care, 2021, 66(7): 1136-1149.
13.	Lagier D, Zeng C, Fernandez-Bustamante A, et al. perioperative pulmonary atelectasis: part II. Clinical implications. Anesthesiol, 2022, 136(1): 206-236.
14.	杜文文, 李鵬, 張玉, 等. 基于決策樹模型的胸腔鏡下肺癌根治術患者術后麻醉恢復室低氧血癥影響因素. 溫州醫科大學學報, 2023, 53(6): 473-481.
15.	廖禮平, 王曙紅. 全身麻醉術后患者蘇醒期并發癥發生情況調查分析. 護理學雜志, 2016, 31(2): 61-63.
16.	陳赟, 趙晶, 張軍, 等. 麻醉蘇醒室患者術后低氧血癥的危險因素分析及護理對策. 護理學雜志, 2022, 37(13): 26-29.
17.	楊正軍, 牛琿, 常虹, 等. 陜西省大骨節病患者關節活動度及肌肉萎縮相關調查. 西安交通大學學報(醫學版), 2024, 45(3): 470-477.
18.	何嘉璟, 馮曉嵐. 全麻下胸腔鏡手術患者麻醉蘇醒期低氧血癥發生的影響因素分析. 中國醫藥導報, 2021, 18(25): 115-118.
19.	Zhang Q, Zhu L, Yuan S, et al. Identifying risk factors for hypoxemia during emergence from anesthesia in patients undergoing robot-assisted laparoscopic radical prostatectomy. J Robot Surg, 2024, 18(1): 200.
20.	Laffin AE, Kendale SM, Huncke TK. Severity and duration of hypoxemia during outpatient endoscopy in obese patients: a retrospective cohort study. Can J Anaesth, 2020, 67(9): 1182-1189.
21.	孫琪琪. 腹部按壓在肥胖患者無痛胃鏡檢查中預防低氧血癥的臨床效果. 汕頭: 汕頭大學, 2024.
22.	馮藝, 許軍軍, 中華醫學會麻醉學分會中國全憑靜脈麻醉臨床實踐指南(2024 版)編寫組. 中國全憑靜脈麻醉臨床實踐指南(2024 版). 中華麻醉學雜志, 2024, 44(9): 1030-1049.
23.	Stewart PA, Liang SS, Li QS, et al. The impact of residual neuromuscular blockade, oversedation, and hypothermia on adverse respiratory events in a postanesthetic care unit: a prospective study of prevalence, predictors, and outcomes. Anesth Analg, 2016, 123(4): 859.
24.	Nagappa M, Weingarten TN, Montandon G, et al. Opioids, respiratory depression, and sleep-disordered breathing. Best Pract Res Clin Anaesthesiol, 2017, 31(4): 469-485.
25.	Pham MQ, Bui HM, Tran TTP, et al. Early postoperative arterial hypoxemia can predict postoperative pulmonary complications. Anaesth Pain Intensi, 2022, 26(2): 137-142.
26.	蔡彬. 不同液體治療策略對老年重大腹部手術圍術期的心腎功能影響: 一項隨機對照研究. 汕頭: 汕頭大學, 2020.
27.	張秋瑜, 鄒宗穎, 朱婉. 顱腦手術患者麻醉蘇醒期低氧血癥發生情況及其影響因素分析. 中西醫結合護理(中英文), 2024, 10(4): 123-125.
28.	蔡慧, 章芊, 魏靈利. 老年病人全身麻醉蘇醒期低氧血癥發生風險預測模型的構建與驗證. 循證護理, 2024, 10(8): 1438-1442.
29.	王宏亮, 王學佳, 張冬. 胸腔鏡胸腺瘤切除手術患者麻醉蘇醒期低氧血癥發生情況及其影響因素分析. 貴州醫藥, 2022, 46(7): 1058-1059.
30.	Kietaibl S, Ahmed A, Afshari A, et al. Management of severe peri-operative bleeding: guidelines from the European Society of Anaesthesiology and Intensive Care: second update 2022. Eur J Anaesthesiol, 2023, 40(4): 226-304.
31.	中華醫學會外科學分會, 中華醫學會麻醉學分會. 中國加速康復外科臨床實踐指南(2021)(一). 中華麻醉學雜志, 2021, 41(9): 1028-1034.
32.	李冬, 朱夢琦, 熊波, 等. 右美托咪定對老年婦科腫瘤患者術后低氧血癥的預防作用及其安全性的臨床研究. 老年醫學與保健, 2024, 30(3): 604-609, 615.
33.	劉熠, 張毅, 唐永忠, 等. 麻醉恢復室低氧血癥預測模型的建立與校驗. 臨床麻醉學雜志, 2021, 37(1): 55-58.
34.	Miller TE, Myles PS. Perioperative fluid therapy for major surgery. Anesthesiol, 2019, 130(5): 825-832.
35.	中華醫學會麻醉學分會氣道學組. 經鼻高流量氧療臨床麻醉規范應用專家共識(2023 版). 臨床麻醉學雜志, 2023, 39(8): 881-887.
36.	Frassanito L, Grieco DL, Zanfini BA, et al. Effect of a pre-emptive 2-hour session of high-flow nasal oxygen on postoperative oxygenation after major gynaecologic surgery: a randomised clinical trial. Br J Anaesth, 2023, 131(4): 775-785.
37.	張鴻, 張軍, 王昕, 等. 食管癌根治術患者麻醉誘導后預置鼻咽通氣道的效果. 護理學雜志, 2023, 38(16): 62-65.
38.	黃鐘萍, 龍朝慶, 盧標清. 鼻內鏡手術對慢性鼻-鼻竇炎患者鼻黏膜纖毛功能、嗅覺功能及術后并發癥的影響. 臨床和實驗醫學雜志, 2024, 23(2): 184-188.
39.	Wang X, Guo K, Sun J, et al. Semirecumbent positioning during anesthesia recovery and postoperative hypoxemia: a randomized clinical trial. JAMA Netw Open, 2024, 7(6): e2416797.
40.	沈莉莉, 吳玲珍. 低體溫危機主動防控結合聽覺刺激—體位變換序貫護理在全身麻醉患者復蘇中的應用. 醫學理論與實踐, 2024, 37(23): 4079-4081.

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2. 鄭榮壽, 陳茹, 韓冰峰, 等. 2022 年中國惡性腫瘤流行情況分析. 中華腫瘤雜志, 2024, 46(3): 221-231.
3. Guo R, Yang WW, Zhong ML, et al. The relationship between anesthesia, surgery and postoperative immune function in cancer patients: a review. Front Immunol, 2024, 15: 1441020.
4. Rudy M, Saller T. Postoperatives delir im aufwachraum. Anaesthesiologie, 2023, 72(7): 459-466.
5. 中華醫學會麻醉學分會. 麻醉后監測治療專家共識. 臨床麻醉學雜志, 2021, 37(1): 89-94.
6. Li H, Zhang Y, Cai J, et al. Risk factors of hypoxemia in the postanesthesia care unit after general anesthesia in children. J Perianesth Nurs, 2023, 38(5): 799-803.
7. 魏時靖, 王強, 劉思晗, 等. 腫瘤病人全身麻醉蘇醒期低氧血癥發生次數的影響因素. 護理研究, 2024, 38(6): 1053-1057.
8. Payne JP, Conway CM. Hypoxaemia after surgery and anaesthesia. Postgrad Med J, 1966, 42(488): 341-350.
9. Blair I, Holland R, Lau W, et al. Oxygen saturation during transfer from operating room to recovery after anaesthesia. Anesth Intensive Care, 1987, 15(2): 147-150.
10. 屠海林, 孫建良, 陸雅萍, 等. 全麻蘇醒期嚴重低氧血癥的原因與處理. 現代實用醫學, 2005, 17(8): 514-515.
11. Dylczyk-Sommer A, Sawicka W, Wujtewicz M. The incidence of postoperative hypoxaemia during transportation to the recovery area. Anestezjol Intens Ter, 2011, 43(2): 68-70.
12. Liu K, Scott JB, Jing G, et al. Management of postoperative hypoxemia. Respir Care, 2021, 66(7): 1136-1149.
13. Lagier D, Zeng C, Fernandez-Bustamante A, et al. perioperative pulmonary atelectasis: part II. Clinical implications. Anesthesiol, 2022, 136(1): 206-236.
14. 杜文文, 李鵬, 張玉, 等. 基于決策樹模型的胸腔鏡下肺癌根治術患者術后麻醉恢復室低氧血癥影響因素. 溫州醫科大學學報, 2023, 53(6): 473-481.
15. 廖禮平, 王曙紅. 全身麻醉術后患者蘇醒期并發癥發生情況調查分析. 護理學雜志, 2016, 31(2): 61-63.
16. 陳赟, 趙晶, 張軍, 等. 麻醉蘇醒室患者術后低氧血癥的危險因素分析及護理對策. 護理學雜志, 2022, 37(13): 26-29.
17. 楊正軍, 牛琿, 常虹, 等. 陜西省大骨節病患者關節活動度及肌肉萎縮相關調查. 西安交通大學學報(醫學版), 2024, 45(3): 470-477.
18. 何嘉璟, 馮曉嵐. 全麻下胸腔鏡手術患者麻醉蘇醒期低氧血癥發生的影響因素分析. 中國醫藥導報, 2021, 18(25): 115-118.
19. Zhang Q, Zhu L, Yuan S, et al. Identifying risk factors for hypoxemia during emergence from anesthesia in patients undergoing robot-assisted laparoscopic radical prostatectomy. J Robot Surg, 2024, 18(1): 200.
20. Laffin AE, Kendale SM, Huncke TK. Severity and duration of hypoxemia during outpatient endoscopy in obese patients: a retrospective cohort study. Can J Anaesth, 2020, 67(9): 1182-1189.
21. 孫琪琪. 腹部按壓在肥胖患者無痛胃鏡檢查中預防低氧血癥的臨床效果. 汕頭: 汕頭大學, 2024.
22. 馮藝, 許軍軍, 中華醫學會麻醉學分會中國全憑靜脈麻醉臨床實踐指南(2024 版)編寫組. 中國全憑靜脈麻醉臨床實踐指南(2024 版). 中華麻醉學雜志, 2024, 44(9): 1030-1049.
23. Stewart PA, Liang SS, Li QS, et al. The impact of residual neuromuscular blockade, oversedation, and hypothermia on adverse respiratory events in a postanesthetic care unit: a prospective study of prevalence, predictors, and outcomes. Anesth Analg, 2016, 123(4): 859.
24. Nagappa M, Weingarten TN, Montandon G, et al. Opioids, respiratory depression, and sleep-disordered breathing. Best Pract Res Clin Anaesthesiol, 2017, 31(4): 469-485.
25. Pham MQ, Bui HM, Tran TTP, et al. Early postoperative arterial hypoxemia can predict postoperative pulmonary complications. Anaesth Pain Intensi, 2022, 26(2): 137-142.
26. 蔡彬. 不同液體治療策略對老年重大腹部手術圍術期的心腎功能影響: 一項隨機對照研究. 汕頭: 汕頭大學, 2020.
27. 張秋瑜, 鄒宗穎, 朱婉. 顱腦手術患者麻醉蘇醒期低氧血癥發生情況及其影響因素分析. 中西醫結合護理(中英文), 2024, 10(4): 123-125.
28. 蔡慧, 章芊, 魏靈利. 老年病人全身麻醉蘇醒期低氧血癥發生風險預測模型的構建與驗證. 循證護理, 2024, 10(8): 1438-1442.
29. 王宏亮, 王學佳, 張冬. 胸腔鏡胸腺瘤切除手術患者麻醉蘇醒期低氧血癥發生情況及其影響因素分析. 貴州醫藥, 2022, 46(7): 1058-1059.
30. Kietaibl S, Ahmed A, Afshari A, et al. Management of severe peri-operative bleeding: guidelines from the European Society of Anaesthesiology and Intensive Care: second update 2022. Eur J Anaesthesiol, 2023, 40(4): 226-304.
31. 中華醫學會外科學分會, 中華醫學會麻醉學分會. 中國加速康復外科臨床實踐指南(2021)(一). 中華麻醉學雜志, 2021, 41(9): 1028-1034.
32. 李冬, 朱夢琦, 熊波, 等. 右美托咪定對老年婦科腫瘤患者術后低氧血癥的預防作用及其安全性的臨床研究. 老年醫學與保健, 2024, 30(3): 604-609, 615.
33. 劉熠, 張毅, 唐永忠, 等. 麻醉恢復室低氧血癥預測模型的建立與校驗. 臨床麻醉學雜志, 2021, 37(1): 55-58.
34. Miller TE, Myles PS. Perioperative fluid therapy for major surgery. Anesthesiol, 2019, 130(5): 825-832.
35. 中華醫學會麻醉學分會氣道學組. 經鼻高流量氧療臨床麻醉規范應用專家共識(2023 版). 臨床麻醉學雜志, 2023, 39(8): 881-887.
36. Frassanito L, Grieco DL, Zanfini BA, et al. Effect of a pre-emptive 2-hour session of high-flow nasal oxygen on postoperative oxygenation after major gynaecologic surgery: a randomised clinical trial. Br J Anaesth, 2023, 131(4): 775-785.
37. 張鴻, 張軍, 王昕, 等. 食管癌根治術患者麻醉誘導后預置鼻咽通氣道的效果. 護理學雜志, 2023, 38(16): 62-65.
38. 黃鐘萍, 龍朝慶, 盧標清. 鼻內鏡手術對慢性鼻-鼻竇炎患者鼻黏膜纖毛功能、嗅覺功能及術后并發癥的影響. 臨床和實驗醫學雜志, 2024, 23(2): 184-188.
39. Wang X, Guo K, Sun J, et al. Semirecumbent positioning during anesthesia recovery and postoperative hypoxemia: a randomized clinical trial. JAMA Netw Open, 2024, 7(6): e2416797.
40. 沈莉莉, 吳玲珍. 低體溫危機主動防控結合聽覺刺激—體位變換序貫護理在全身麻醉患者復蘇中的應用. 醫學理論與實踐, 2024, 37(23): 4079-4081.

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Research progress on hypoxemia during the recovery period after general anesthesia in tumor patients

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