This study aims to evaluate whether guidance by the Oxygen Reserve Index (ORi) improves inspiratory oxygen fraction (FiO₂) titration compared with conventional pulse oximetry (SpO₂)-guided oxygen administration in adult patients undergoing surgery in the beach chair position.
Oxygen therapy is routinely used during general anesthesia to prevent hypoxemia; however, excessive oxygen administration may result in hyperoxia, which has been associated with adverse cardiovascular and pulmonary effects. Standard pulse oximetry may not adequately detect hyperoxia when oxygen saturation values are high.
In this prospective comparative study, patients will receive oxygen titration guided either by SpO₂ alone or by combined ORi and SpO₂ monitoring. The primary outcome is the incidence of intraoperative hyperoxemia, assessed by arterial blood gas analysis. Secondary outcomes include intraoperative oxygenation parameters and hemodynamic variables.
Adult patients aged 18 to 65 years
American Society of Anesthesiologists (ASA) physical status I-III
Scheduled for elective orthopedic surgery in the beach chair position
Body mass index (BMI) <35 kg/m²
Age <18 or ≥65 years
Finger deformities preventing the use of Oxygen Reserve Index (ORi) monitoring
Severe anemia (hemoglobin <8 g/dL)
Pregnancy