The early postoperative course of surgical sleep apnea patients

Abstract

The incidence of respiratory events requiring intervention in the early postoperative course of OSA patients was low (3.4%). Routine postoperative inpatient monitoring may not be required in many cases.

Admission after sleep surgery is unnecessary in patients without cardiovascular disease

“…This is in line with recent work from our center wherein we examined 121 patients with sleep study‐proven OSA (AHI 31.9 ± 22.7) who underwent multilevel sleep apnea surgery. The incidence of nursing intervention in response to respiratory complications was 3.4%, which was significantly less than quoted by the ASA guidelines . An even more recent review by Pang's group in Singapore demonstrated a low 1.8% incidence of respiratory complications in 487 patients, with eight of the nine complications being noted within 3 hours of surgery while still in PACU, and six of nine being simple desaturations with no adverse consequences .…”

“…All patients who screened for admission by SORT criteria were transferred to our institution's sleep apnea overnight‐monitoring room for 24 hours of continuous observation. Complications, if any, were recorded as per the protocol of our previous study (see Table ) …”

“…Modern evidence does not support this admission practice. Published research from our institution and others has shown that the rate of any adverse respiratory event following OSA surgery is far lower than the historical literature indicated; most respiratory events are only simple desaturations . Moreover, those adverse respiratory events that do occur overwhelmingly tend to occur within a few hours after surgery, suggesting that in many cases overnight monitoring may be neither necessary nor beneficial .…”

Is overnight monitoring required for adult patients undergoing surgery for obstructive sleep apnea?

“…This study found that the incidence of respiratory events (all being oxygen desaturations) in the early postoperative course was low (3.4%), and that all such patients were all identified within 4 hours of surgery. The incidence of adverse respiratory events was too small in this study to be able to predict risk factors thereof 6…”

The incidence of early post-operative complications following uvulopalatopharyngoplasty: Identification of predictive risk factors

“…More recently, studies have argued that in selected patients UPPP can be performed as an outpatient surgery [6-10]. These studies have consistently shown that complications rates are low, that more severe complications tend to occur while still in recovery room, and no postoperative mortality.…”