Obstructive sleep apnoea syndrome in children

Abstract

SummaryObstructive sleep apnoea syndrome in children is a complex disorder characterised by repeated nocturnal episodes of increased upper airway resistive load. It is most commonly associated with adenotonsillar hypertrophy and more children are now presenting for adenotonsillectomy. These children may pose different anaesthetic problems to those having surgery for recurrent infection alone and anaesthetic morbidity and mortality has been reported. In addition, due to the varied symptomatology of the condition, children with unrecognised obstructive sleep apnoea syndrome may present for incidental surgery. This is of importance as patients with undiagnosed obstructive sleep apnoea syndrome may experience additional peri-operative morbidity when undergoing incidental surgery. This article aims to review the aetiology, pathophysiology, clinical presentation and anaesthetic management of children with obstructive sleep apnoea syndrome.

Persistent snoring under conscious sedation during colonoscopy is a predictor of obstructive sleep apnea

“…This has led some authors to warn that the use of sedative premedication for surgery in OSA patients should be avoided because it may exacerbate airway obstruction. 34,35 Although endoscopists generally aim to achieve moderate sedation, deep sedation was noted in 68% of patients undergoing endoscopy, with at least 1 episode in 45% of colonoscopy patients sedated with midazolam and meperidine. 36 In a recent study, apnea developed in 62.6% of patients receiving narcotic-and benzodiazepine-based CS for ERCP or EUS, defined as the absence of respiratory activity for 15 seconds or longer on capnographic monitoring.…”

Anesthetic management of pediatric adenotonsillectomy

“…Children with OSAS undergoing adenotonsillectomy are at significant risk of respiratory and cardiovascular complications, with a reported incidence up to 20%. 1,2 Children at particular risk are the very young (< 2 yr) and those with significant co-morbidity. 3 …”

Anesthesia and sleep apnea syndrome

“…Bei Kin dern kann die kra nio fa zia le Physio gno mie mit Ma kro glos sie und Mi krogna thie Hin wei se auf ein SAS ge ben [101]. Ver hal tens auf fäl lig kei ten und schlech te schu li sche Leis tun gen sind neu ro ko gni tive Äqui va len te zur Ta ges mü dig keit der Erwach se nen.…”