Obstructive Sleep Apnea and Metabolic Syndrome

Kareem, Ozaifa; Tanvir, Masood; Bader, Ghulam Nabi

doi:10.1007/s41782-022-00204-5

Cited by 3 publications

(2 citation statements)

References 162 publications

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“…Conversely, OSAS itself may promote weight gain and make weight loss more difficult. [27] What is more, OSAS has been independently associated with insulin resistance, even after adjusting for obesity and other confounding factors. The severity of OSAS correlates with the degree of insulin resistance.…”

Section: Metabolic Disordersmentioning

confidence: 99%

Health consequences of Obstructive Sleep Apnoea Syndrome

Szewczyk,

Krzesłowska

et al. 2024

J Educ Health Sport

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Introduction: Obstructive Sleep Apnoea Syndrome (OSAS) is a common sleep disorder characterized by recurrent episodes of partial or complete upper airway obstruction during sleep. OSAS affects millions of people worldwide, with varying degrees of severity. It contributes to a range of adverse health outcomes, including cardiovascular, neurocognitive, metabolic, and psychosocial effects. Understanding the wide-ranging impact of OSAS is crucial in emphasizing the importance of early recognition, accurate diagnosis, and tailored interventions to improve the quality of life for affected individuals. Aim of the study: The aim of this study is to explore the diverse health consequences of OSAS and highlight the importance of early recognition, accurate diagnosis, and tailored interventions for managing this sleep disorder effectively. By understanding the impact of OSAS on various aspects of health, we can emphasize the need for comprehensive evaluation and a multidisciplinary approach to improve the overall health of individuals affected by OSAS.

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Section: Metabolic Disordersmentioning

confidence: 99%

Health consequences of Obstructive Sleep Apnoea Syndrome

Szewczyk,

Krzesłowska

et al. 2024

J Educ Health Sport

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“…Менш відомий побічний ефект -це слабкість м›язів глотки, що сприяє розвитку обструкції дихальних шляхів пацієнта. Ці питання стають особливо актуальними при анестезії у пацієнтів з ожирінням [15], геріатричних хворих, та у тих, хто має обструктивний апное сну [16,17]. Незважаючи на те, що критичні стани пов'язані з опіоїд-індукованим порушенням вентиляції легень є не частими, однак гіпоксемія, пов'язана з опіоїдною аналгезією є досить високою 12,5-20% [18].…”

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Аssessment of the antinociceptive efficacy of varieties of multimodal low-opioid general anesthesia during laparoscopic renal surgery

Ovsiienko

Bondar

Лоскутов

2022

Ukr. J. Nephrol. and Dial.

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The main premise for the emergence of the concept of low-opioid general anesthesia was the phenomenon of the formation of drug/opioid dependence in patients undergoing surgery under multicomponent anesthesia with high doses of narcotic analgesics (opioids). Opioids were used as the main analgesics and in the postoperative period. The above factors contributed to the development of opiate addiction in operated patients in the late postoperative period. The mass nature of this phenomenon has become one of the most urgent problems in modern anesthesiology. Our study aimed to evaluate the antinociceptive/antistress efficacy of 3 types of low-opioid multimodal general anesthesia in laparoscopic renal surgery. Methods. Eighty patients who had undergone laparoscopic renal surgery under 3 types of general anesthesia were included in this prospective cohort study. All patients were operated under general anesthesia with tracheal intubation. Induction: intravenous (IV) propofol 2 mg/kg, fentanyl 1.5-2 μg/kg, atracurium 0.6 mg/kg. Maintenance of anesthesia: sevoflurane (MAC - 1.44±0.25% by volume). In group 1 (control group n = 26), analgesia was provided with fentanyl 3,89±2.03 μg/kg/h. In group 2 (n = 25), multimodal low-opioid general anesthesia was performed with fentanyl 1.76±1.2 μg/kg/h and IV lidocaine 1.5 mg/kg/h and subanesthetic doses of ketamine. In group 3 (n = 29), multimodal anesthesia with low opioids was performed with fentanyl 2.38±1.01 μg/kg/h in combination with dexmedetomidine 0.7 μg/kg/h. The efficacy of antinociceptive protection was assessed by the dynamics of changes in stress hormone levels, hemodynamic parameters, and blood glucose concentration. Results. The mean total dose of fentanyl used throughout the anesthetic period was: 369,23±83,75 μg in group 1, 216,0±47,26 μg in group 2, and 272,41±58,14 μg in group 3 (p < 0.001). Mean cortisol levels were significantly different before and after surgery in groups 1 and 2: 371,0±161,61 nmol/l vs 562,72±226,87 nmol/l (p < 0.01) and 531,08±218,02 nmol/l vs 831,33±235,32 nmol/l (p < 0.01), respectively. In group 3, we did not detect any statistical difference: 393,51±134,69 nmol/l and 436,37±188,09 nmol/l, respectively (p > 0.05). The mean level of adrenocorticotropic hormone increased significantly after surgery in all studied groups: 111.86% in group 1 (p < 0.01), 122.02% (p < 0.01) in group 2 and 78.59% (p < 0.01) in group 3. Blood glucose levels in the postoperative (p/o) period did not exceed 6,16±1,67 mmol/l (p > 0.05) in all groups. Hemodynamic parameters and BIS, which were maintained within 44±6.4%, indicated the adequacy of anesthesia and analgesia in the study groups. In group 1, 8 of 26 patients required additional analgesia with opioids during the p/o period (pain intensity on the VAS scale exceeded 4 points). In group 2 and group 3, 4 patients each required opioid analgesia, 16% and 15.38%, respectively. The next day after surgery, all patients were mobilized (sitting in bed, walking). Markers of renal function were also within normal range in all patients. Conclusion. The use of low-opioid multimodal anesthesia with IV lidocaine or dexmedetomidine during laparoscopic renal surgery provides an adequate anesthetic/antinociceptive effect. The use of dexmedetomidine in multimodal general anesthesia provides the greatest antinociceptive protection and reduces the stress response to surgery.

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