Perioperative management of obstructive sleep apnea: a survey of Puerto Rico anesthesia providers

Olmo-Arroyo, Francisco Del; Hernandez-Castillo, R.A.; Soto, Antonio; Martínez, Juancarlo; Rodríguez-Cintrón, William

doi:10.1007/s11325-015-1124-z

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…Similar to the effects of neuromuscular blockers, upper airway muscles are more sensitive than the diaphragm or intercostal muscles to relaxation by anesthetics, which results in loss of muscle tone and upper airway obstruction, which can be defined as negative airway pressure resulting in flow limitation or airway collapse [ 109 , 110 ]. Notably, patients with a tendency for upper airway obstruction during sleep are also more vulnerable during anesthesia and sedation [ 110 , 111 ].…”

Section: Behavioral Characteristics Of Respiration Are Modulated By G...mentioning

confidence: 99%

The Modulation by Anesthetics and Analgesics of Respiratory Rhythm in the Nervous System

Hao

Yang

Liu

et al. 2024

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Rhythmic eupneic breathing in mammals depends on the coordinated activities of the neural system that sends cranial and spinal motor outputs to respiratory muscles. These outputs modulate lung ventilation and adjust respiratory airflow, which depends on the upper airway patency and venti- latory musculature. Anesthetics are widely used in clinical practice worldwide. In addition to clinically necessary pharmacological effects, respiratory depression is a critical side effect induced by most gen- eral anesthetics. Therefore, understanding how general anesthetics modulate the respiratory system is important for the development of safer general anesthetics. Currently used volatile anesthetics and most intravenous anesthetics induce inhibitory effects on respiratory outputs. Various general anes- thetics produce differential effects on respiratory characteristics, including the respiratory rate, tidalvolume, airway resistance, and ventilatory response. At the cellular and molecular levels, the mechanisms underlying anesthetic-induced breathing depression mainly include modulation of synaptictransmission of ligand-gated ionotropic receptors (e.g., γ-aminobutyric acid, N-methyl-D-aspartate,and nicotinic acetylcholine receptors) and ion channels (e.g., voltage-gated sodium, calcium, and po-tassium channels, two-pore domain potassium channels, and sodium leak channels), which affect neu-ronal firing in brainstem respiratory and peripheral chemoreceptor areas. The present review compre-hensively summarizes the modulation of the respiratory system by clinically used general anesthetics,including the effects at the molecular, cellular, anatomic, and behavioral levels. Specifically, analgesics, such as opioids, which cause respiratory depression and the “opioid crisis”, are discussed. Finally, underlying strategies of respiratory stimulation that target general anesthetics and/or analgesics aresummarized.

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Section: Behavioral Characteristics Of Respiration Are Modulated By G...mentioning

confidence: 99%

The Modulation by Anesthetics and Analgesics of Respiratory Rhythm in the Nervous System

Hao

Yang

Liu

et al. 2024

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“…( 8) Issue (1) (2023( patients. This section explores the current strategies and interventions employed in the perioperative care of OSA patients [22] .  Preoperative Screening and Evaluation:…”

Section: Perioperative Strategies For Managing Osamentioning

confidence: 99%

Sleep-Related Breathing Disorder and its Relation to Anesthetic Practice

Ibrahim,

Abelgheit,

Hassan

2023

Benha Journal of Applied Sciences

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Background: Sleep-related breathing disorders, particularly obstructive sleep apnea (OSA), pose significant challenges in anesthesia practice. Understanding the relationship between OSA and anesthesia is crucial for ensuring safe perioperative management. Objectives: review the latest updates about obstructive sleep apnea, and how it affects the field of anesthesia as a crucial coexisting disease. furthermore, how to establish peri-operative strategies to manage OSA cases. Conclusions: Effective perioperative management of OSA patients requires a multidisciplinary approach, including collaboration between anesthesia providers, sleep specialists, and other healthcare professionals. Preoperative screening and evaluation, careful selection of anesthetic techniques and agents, and the implementation of non-pharmacological interventions such as continuous positive airway pressure (CPAP) therapy are essential. Future research should focus on precision medicine approaches, biomarkers, predictive models, novel monitoring technologies, and standardized protocols to further optimize perioperative care for OSA patients. By addressing these challenges and advancing knowledge, anesthesia practice can enhance the safety and outcomes of OSA patients undergoing surgery.

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Implementation of an Obstructive Sleep Apnea Protocol in the Postanesthesia Care Unit for Patients Undergoing Spinal Fusion Surgery

Wortham¹,

Rice²,

Gupta³

et al. 2019

Journal of PeriAnesthesia Nursing

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Perioperative management of obstructive sleep apnea: a survey of Puerto Rico anesthesia providers

Abstract: There is a significant heterogeneity in the current clinical practice. The main barriers identified to achieve current recommendations were lack of institutional policies, awareness of current guideline, formal training in management of OSA, and access to a sleep specialist.

Cited by 4 publications

References 22 publications

The Modulation by Anesthetics and Analgesics of Respiratory Rhythm in the Nervous System

The Modulation by Anesthetics and Analgesics of Respiratory Rhythm in the Nervous System

Sleep-Related Breathing Disorder and its Relation to Anesthetic Practice

Implementation of an Obstructive Sleep Apnea Protocol in the Postanesthesia Care Unit for Patients Undergoing Spinal Fusion Surgery

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