Influence of surgical technique on early postoperative hypoxaemia in children undergoing elective palatoplasty

We have assessed the influence of different surgical procedures on the incidence, severity and duration of early postoperative hypoxaemia in 312 healthy infants and children undergoing elective palatoplasty. Group 1 patients underwent von Langenbeck palatoplasty (n = 149), group 2 patients underwent push-back palatoplasty (n = 124) and group 3 patients underwent combined push-back palatoplasty and superior pharyngeal flap surgery (n = 39). Arterial oxygen saturation (SpO2) was recorded while patients were breathing air shortly after arrival in the recovery room (0 min), and at 5, 10, 15, 20, 30, 40, 50, 60, 120 and 180 min thereafter. Patients who underwent more complex surgical techniques for palatoplasty had lower postoperative SpO2 values, slower recovery of SpO2 and a higher incidence of hypoxaemia during the early postoperative period. There were significant differences in postoperative SpO2, values and the incidence of hypoxaemia. The incidences of hypoxaemia and severe hypoxaemia were 27% and 1%, respectively, in group 1, 37% and 12% in group 2, and 36% and 33% in group 3. Hypoxaemia occurred most commonly in the first 15 min in children after von Langenbeck palatoplasty, in the first 40 min after push-back palatoplasty and in the 120 min after combined push-back palatoplasty and superior pharyngeal flap surgery. There were significant associations between low SpO2 values, incidence of hypoxaemia on admission to the recovery room and recovery scores.