Evaluation of Correlation of Preoperative Vitamin D Levels with Respiratory Complications in Patients undergoing General Anaesthesia

Introduction: Respiratory problems are a significant cause of mortality and morbidity during the peri-operative period and they warrant significant attention.Serum Vitamin D levels and pulmonary function and inflammatory responses are known to be correlated.In respiratory disorders including bronchial asthma, COPD, and pneumonia, this association is quite obvious.Studies on the inflammatory pathway, airway constriction, and remodelling processes of smooth muscle cells in the airways revealed that vitamin D may modulate these processes.Aims/ objective: to determine whether pre-operative vitamin D levels were associated with respiratory issues during induction, extubation, and early post-operative period in patients undergoing elective abdominal surgery under general anaesthesia.Materials and Method: General anaesthesia was maintained through Sevoflurane 2 percent, remifentanil 0.25 mg per kg per min infusion, 2 litters oxygen + two litters dry air with 0.8 ml per kg tidal volume at a rate of 12/min, and maintenance of end-tidal CO2 level between 30 to 35 mmHg.At the last moment of surgical procedures, neostigmine at dose of 0.05 mg per kg and atropine at dose of 0.02 mg per kg were administered and then subjects were extubated.Incidence of cough, bronchospasm or desaturation of blood oxygen levels (SpO2 < 90%) were recorded during intubation, extubation and during recovery from anaesthesia Results: Overall, there was greater incidence of respiratory complication in patients with vitamin D deficiency.Incidence of desaturation (SpO2<90%) in recovery phase (50.00%) in patients with vitamin D deficiency was significantly greater than the incidence (23.53%) in patients with serum vitamin D greater than 20 ng/ml (p<0.05).Incidence of bronchospasm and cough was also greater in patients with low serum vitamin D levels.Serum vitamin D levels was significantly lower in patients with respiratory complication with greatest correlation with desaturation (SpO2<90%).Conclusion: There was a significant positive correlation between serum vitamin D levels and incidence of intra-operative and postoperative respiratory complications.We suggest that correcting serum vitamin D levels in the pre-operative period will be helpful in terms of reducing respiratory issues for elective surgery, particularly for patients in the older age group.