To investigate if sex-specific physiologic characteristics could impact postoperative respiratory depression risks in women, we studied incidence and risk factors associated with postoperative respiratory depression in a gynecologic surgical cohort. Only hysterectomies performed under general anesthesia from 2012 to 2017 were included to minimize interprocedural variability. Respiratory depression was defined as episodes of apnea, hypopnea, hypoxemia, pain-sedation mismatch, unplanned positive airway pressure device application, or naloxone administration in the post-anesthesia care unit. Multivariable logistic regression was used to explore the association with clinical characteristics. From 1,974 hysterectomies, 253 had postoperative respiratory depression, yielding an incidence of 128 (95% confidence interval, 114-144) per 1,000 surgeries. Risk factors associated with respiratory depression were older age (odds ratio 1.22 [95% confidence interval 1.02-1.46] per decade increase, p = 0.03), lower body weight (0.77 [0.62-0.94] per 10 kg/m2, p = 0.01), and higher intraoperative opioid dose (1.05 [1.01-1.09] per 10 mg oral morphine equivalents, p = 0.01); while sugammadex use was associated with a reduced risk (0.48 [0.30-0.75], p = 0.002). Respiratory depression was not associated with increased hospital stay, postoperative complications, or mortality. Postoperative respiratory depression risk in women increased with age, lower weight, and higher intraoperative opioids and decreased with sugammadex use; however, it was not associated with postoperative pulmonary complications.

中文翻译：

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子宫切除术后呼吸抑制。

为了调查性别特异性生理特征是否会影响女性术后呼吸抑制的风险，我们在妇科手术队列中研究了与术后呼吸抑制相关的发病率和危险因素。仅包括 2012 年至 2017 年在全身麻醉下进行的子宫切除术，以尽量减少手术间的差异。呼吸抑制被定义为呼吸暂停、呼吸不足、低氧血症、镇痛镇静不匹配、意外使用气道正压装置或在麻醉后监护室使用纳洛酮。多变量逻辑回归用于探索与临床特征的关联。从 1,974 次子宫切除术中，253 次出现术后呼吸抑制，每 1,000 次手术的发生率为 128（95% 置信区间，114-144）。与呼吸抑制相关的危险因素是年龄较大（每十年增加的比值比 1.22 [95% 置信区间 1.02-1.46]，p = 0.03）、较低的体重（每 10 kg/m2 0.77 [0.62-0.94]，p = 0.01 )，以及更高的术中阿片类药物剂量（每 10 毫克口服吗啡当量 1.05 [1.01-1.09]，p = 0.01）；而 sugammadex 的使用与风险降低相关（0.48 [0.30-0.75]，p = 0.002）。呼吸抑制与住院时间增加、术后并发症或死亡率无关。女性术后呼吸抑制风险随着年龄、体重减轻和术中阿片类药物用量增加而增加，并随着舒更葡糖的使用而降低；然而，它与术后肺部并发症无关。46] 每十年增加，p = 0.03），降低体重（每 10 kg/m2 0.77 [0.62-0.94]，p = 0.01）和更高的术中阿片类药物剂量（1.05 [1.01-1.09] 每 10 mg 口服吗啡当量） , p = 0.01); 而 sugammadex 的使用与风险降低相关（0.48 [0.30-0.75]，p = 0.002）。呼吸抑制与住院时间增加、术后并发症或死亡率无关。女性术后呼吸抑制风险随着年龄、体重减轻和术中阿片类药物用量增加而增加，并随着舒更葡糖的使用而降低；然而，它与术后肺部并发症无关。46] 每十年增加，p = 0.03），降低体重（每 10 kg/m2 0.77 [0.62-0.94]，p = 0.01）和更高的术中阿片类药物剂量（1.05 [1.01-1.09] 每 10 mg 口服吗啡当量） , p = 0.01); 而 sugammadex 的使用与风险降低相关（0.48 [0.30-0.75]，p = 0.002）。呼吸抑制与住院时间增加、术后并发症或死亡率无关。女性术后呼吸抑制风险随着年龄、体重减轻和术中阿片类药物用量增加而增加，并随着舒更葡糖的使用而降低；然而，它与术后肺部并发症无关。而 sugammadex 的使用与风险降低相关（0.48 [0.30-0.75]，p = 0.002）。呼吸抑制与住院时间增加、术后并发症或死亡率无关。女性术后呼吸抑制风险随着年龄、体重减轻和术中阿片类药物用量增加而增加，并随着舒更葡糖的使用而降低；然而，它与术后肺部并发症无关。而 sugammadex 的使用与风险降低相关（0.48 [0.30-0.75]，p = 0.002）。呼吸抑制与住院时间增加、术后并发症或死亡率无关。女性术后呼吸抑制风险随着年龄、体重减轻和术中阿片类药物用量增加而增加，并随着舒更葡糖的使用而降低；然而，它与术后肺部并发症无关。