Role of perioperative oxygen supplementation in relation to surgical site infection in urological surgery under neuraxial anesthesia

Background Hyperoxia exerts variable effects on multiple cellular and immunologic parameters and offers potential benefits from use of supplemental oxygen. Supplementation with high concentration of O2 has been shown to reduce colorectal anastomotic leakage by 50% and subsequently its use has been recommended to reduce surgical site infection (SSI) by surgical associations of America and Canada. We designed this randomized controlled trial to determine the impact of O2 supplementation on the incidence of SSI in urological surgeries performed under neuraxial anaesthesia. Aim The aim of the study was to evaluate whether use of supplemental high-concentration perioperative oxygen decreases the risk of post-uro-SSI as it did after colorectal surgery in previous studies. Settings The study was conducted in the Department of Anaesthesiology and Critical Care in collaboration with the Department of Urology at our institute after obtaining clearance from the Institute of Ethical Committee and written informed consent from patients enrolled in this study. Patients and methods Eighty ASA grade I and II patients, aged between 15 and 60 years, undergoing selected urological surgeries were randomly assigned to two equal groups after they had fulfilled inclusion and exclusion criteria. One group received 8–10 l O2/min through a non-rebreathing face mask during the intraoperative period, which was continued in the postoperative period for about 6 h, whereas the other group continued breathing room air. Data were collected by physicians from the Department of Urology who were blinded to the intervention and were analysed using INSTAT software with appropriate statistical tools. Results Demographic, physical, preoperative, intraoperative and postoperative haemodynamic parameters in both groups were comparable (P 0.05). Although our study showed a tendency towards reduction in SSI (17.5 vs. 12.5%), compared with the control group, the difference was not statistically significant (P 0.05). Conclusion Perioperative high-concentration oxygen supplementation does not reduce SSI in clean contaminated types of wounds in urological surgeries.