Perioperative Complications in Obstructive Sleep Apnea Patients

Abstract

Obstructive sleep apnea (OSA) is growing in prevalence though it still remains significantly underdiagnosed. Preoperative screening for OSA is taking place in many institutions, with a substantial number of patients being identified as having a high probability for OSA just prior to undergoing surgery. Emerging data increasingly demonstrates that patients with a high probability of having OSA as well as those with a known diagnosis of OSA may be at increased risk for developing complications in the perioperative setting. Postoperative cardiac and pulmonary adverse events appear to occur more frequently in these patients though the impact OSA has on postoperative mortality is controversial. In addition, determining which patients are at greatest risk remains an area of uncertainty. This chapter will review the current state of the knowledge regarding OSA as a risk factor for perioperative complications.

Patient Selection for Adult Ambulatory Surgery: A Narrative Review

“…Numerous studies in hospitalized patients have reported association between OSA and adverse perioperative outcomes including reintubation, need for noninvasive ventilation, and adverse cardiac outcomes. 62,63 However, the evidence linking OSA with perioperative complications is marred by inconsistent quality, heterogeneity, and inability to clearly establish OSA, as opposed to the various comorbidities associated with it, as an independent risk factor for adverse outcomes. The vast majority of surgical patients do not have an established diagnosis of OSA or, if they do, are not compliant with prescribed positive airway pressure (PAP) therapy.…”