Abstract: PURPOSE: To explore the influencing factors of hypoxemia during the anesthesia recovery period in patients undergoing oral and maxillofacial surgery. METHODS: A retrospective cohort study design was adopted. A total of 1 417 patients undergoing oral and maxillofacial surgery who were monitored in the post-anesthetic care unit of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2024 to December 2024 were included. According to the occurrence of hypoxemia during the anesthesia recovery period, they were divided into the hypoxemia group(n=61, SpO₂ < 90% or PaO₂ < 60 mmHg) and the normal control group (n=1 356). Univariate analysis of variance and multivariate logistic regression models were used to screen the independent predictors of hypoxemia during the anesthesia recovery period, and a risk warning index system was constructed. RESULTS: The overall incidence of hypoxemia was 4.30% (61/1 417). Multivariate analysis revealed that ASA classification ≥Ⅲ(OR=6.61, 95%CI: 4.12-10.58), comorbid obstructive sleep apnea (OSA) (OR=5.93, 95%CI: 3.82-9.17), and ≥3 postoperative airway suction episodes (OR=3.35, 95%CI: 2.24-5.01) served as independent risk factors. CONCLUSIONS: The occurrence of hypoxemia during the anesthesia recovery period in patients undergoing oral and maxillofacial surgery is significantly associated with ASA classification, coexisting OSA status, and airway management operations. It is recommended to implement a multimodal recovery plan based on risk stratification, optimize perioperative respiratory function monitoring, and formulate individualized airway management nursing strategies.

Key words: Oral and maxillofacial surgery, Postoperative hypoxemia, Anesthesia recovery period, Nursing strategies, Influence factors