Keywords
Infección del sitio quirúrgico
Anestesia general
Meta-análisis
Análisis secuencial de experimentos Supplemental oxygen
Surgical site infection
General anesthesia
Meta-analysis
Trial
Sequential analysis
How to Cite
Abstract
Background: In almost all anesthetic procedures, oxygen is administered routinely to patients. However, the concentration used varies between 30 and 100%. It has been considered that administration of a high fraction of inspired oxygen (FiO2) could reduce the risk of surgical site infection (SSI). Objective: to evaluate the effectiveness of higher FiO2 (≥ 60%) compared with lower FiO2 (≤ 40%) to decrease the risk of SSI in patients undergoing surgical procedures under general anesthesia, through the tool of sequential analysis of experiments. Materials and methods: we conducted a sequence analysis of experiments using a systematic review with the Cochrane Collaboration methodology, and recommendations of the declaration PRISMA, the R-AMSTAR instrument and the group of Dr. Wetterslev. Results: we found seven studies that pooled 4480 patients. We did not find FiO2 differences when pooling all studies (OR 0.73 [0.50, 1.05]). However, when we analyzed only studies in which all participants underwent to intestinal resection, resulted in a significant reduction in the risk of SSI (OR 0.45 [0.30, 0.69]). This effect was unchanged when analyzing only studies with low risk of bias (OR 0.46 [0.29, 0.74]). There was no evidence of publication bias. Sequence analysis of experiments can establish that this meta-analysis provides firm evidence. Conclusion: the use of supplemental oxygen in high concentrations (FiO2 ≈ 80%) during general anesthesia, reduces the risk of SSI when performing intestinal resection procedures (eg. colorectal surgery). However, this effect was not present when analyzing the general surgical population.
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