Conservation of Resources: Indications for Intensive Care Monitoring After Upper Airway Surgery on Patients With Obstructive Sleep Apnea

Abstract

Although significant complications can result after upper airway surgery for obstructive sleep apnea (OSA), there is a lack of consensus regarding the most appropriate level of monitoring in the perioperative period. A retrospective analysis was performed on the operative records of 109 adult patients who underwent 125 surgical procedures from January 1, 1991, to May 31, 1996, with particular emphasis on complications that would have mandated intensive care monitoring and management. Airway complications occurred in one patient (0.8%), who became obstructed immediately after surgery; he responded to naloxone and suctioning. Five other patients (4%) suffered oxygen desaturation to levels below 90% (none fell below 80%, and in only one case was it below the lowest preoperative oxygen saturation level). Cardiac complications, primarily significant hypertension, were the most common adverse events. Four (3.2%) bleeding complications were encountered; all occurred after discharge from the hospital. Routine postoperative intensive care monitoring for all adult patients undergoing upper airway surgery for OSA is unnecessary. Although high-risk patients cannot always be identified preoperatively, significant complications generally emerge within 2 hours after surgery. Therefore a decision regarding the level of postoperative monitoring needed may be made with confidence during the period of time that the patient is in the recovery room.

Postoperative complications in patients with obstructive sleep apnea: a retrospective matched cohort study

“…Most previously published studies examining postoperative complications in OSA patients focused on patients who underwent upper airway surgeries. [25][26][27][28][29][30][31] Only a few studies have evaluated postoperative complications in patients who underwent other types of surgery. 22,[32][33][34][35][36] Our study complements this growing body of literature by demonstrating that OSA patients undergoing different types of surgery have an increased rate of postoperative complications, mainly oxygen desaturation.…”

Cosmetic Enhancement Associated With Surgery for Obstructive Sleep Apnea

“…Although no patients in this limited subset of our surgical experience suffered any substantial complications, there are known risks of these procedures, several of which have been described in our broader experience, 6 and include bleeding, infection, hematoma of the floor of mouth, dental root injury, mandible fracture, palatal slough, septal perforation, rhinitis sicca, and cobra deformity (accentuation of the anterior platysma muscle edges as a result of overzealous submental fat removal).…”

Frequency of serious complications after surgery for snoring and sleep apnea

“…In a recent systematic review, it was found that UPPP was followed by severe complications in the peri-and postoperative period, including death, bleedings, and respiratory compromise, in 0-16% of patients [7][8][9][10][11][12][13][14][15][16][17][18][19]. A total of 30 cases of death were reported from 7 studies [7,8,[10][11][12]20,21].…”