LAUSR

Overnight pulse oximetry is often used to determine severity of sleep apnoea and likelihood of post-operative complications with a view to planning whether high dependency care (HDU) might be required but may introduce delays and cost into the patient pathway. In 82 children without co morbidities, mild post-operative respiratory complications requiring repositioning or oxygen occurred in 15 (36.6%) in those with severely abnormal oximetry (SpO2 4% dip index > 10/hr and/or SpO2 nadir <80%) and 4 (9.8%) in matched controls. Four patients in the severe group had serious complications requiring a more intensive intervention, all of which occurred within 6 hours of surgery. In hospitals with HDU facilities children without comorbidities may be safely managed as day cases and do not require pre-op oximetry. Any child with an oxygen requirement should be admitted and the 10% that require unplanned admission will be apparent within 6 hours. In hospitals without HDU facilities we suggest overnight oximetry is performed and children with severely abnormal studies transferred to a centre with HDU. Other cases could be managed safely as day-surgery with admission if there is a significant oxygen requirement after 6 hours. This article is protected by copyright. All rights reserved.