The prevalence of perioperative complications in patients with and without obstructive sleep apnoea: a prospective cohort study

Tatiana, Ambrosii; Șandru, Serghei; Belîi, Adrian

doi:10.21454/rjaic.7518/232.pec

Cited by 6 publications

(3 citation statements)

References 37 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Subsequent studies 236 , 239 confirmed the previous findings, while 1 suggested benefits with regard to mortality. 239 Notably, in a prospective analysis investigating drivers of postoperative worsening of sleep-disordered breathing, Chung et al 79 demonstrated that the utilization of general anesthesia was associated with an increased central apnea index postoperatively, while 72-hour total opioid dose was a driver of increased AHI.…”

Section: Anesthesia Techniquesupporting

confidence: 63%

Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea

Memtsoudis

Cozowicz

Nagappa

et al. 2018

Anesthesia &Amp; Analgesia

137

158

View full text Add to dashboard Cite

The purpose of the Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea (OSA) is to present recommendations based on current scientific evidence. This guideline seeks to address questions regarding the intraoperative care of patients with OSA, including airway management, anesthetic drug and agent effects, and choice of anesthesia type. Given the paucity of high-quality studies with regard to study design and execution in this perioperative field, recommendations were to a large part developed by subject-matter experts through consensus processes, taking into account the current scientific knowledge base and quality of evidence. This guideline may not be suitable for all clinical settings and patients and is not intended to define standards of care or absolute requirements for patient care; thus, assessment of appropriateness should be made on an individualized basis. Adherence to this guideline cannot guarantee successful outcomes, but recommendations should rather aid health care professionals and institutions to formulate plans and develop protocols for the improvement of the perioperative care of patients with OSA, considering patient-related factors, interventions, and resource availability. Given the groundwork of a comprehensive systematic literature review, these recommendations reflect the current state of knowledge and its interpretation by a group of experts at the time of publication. While periodic reevaluations of literature are needed, novel scientific evidence between updates should be taken into account. Deviations in practice from the guideline may be justifiable and should not be interpreted as a basis for claims of negligence.

show abstract

Section: Anesthesia Techniquesupporting

confidence: 63%

Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea

Memtsoudis

Cozowicz

Nagappa

et al. 2018

Anesthesia &Amp; Analgesia

137

158

View full text Add to dashboard Cite

show abstract

“…For simple dental surgery or procedures, local or regional anesthesia is preferred over general anesthesia. Postoperative outcomes may improve when regional anesthesia is used instead of general anesthesia [ 74 75 ]. For procedures requiring moderate sedation, pulse oximetry and/or capnography should be monitored for the early detection of airway obstruction or respiratory depression.…”

Section: Perioperative Managementmentioning

confidence: 99%

Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review

Bae

2023

J Dent Anesth Pain Med

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA is characterized by recurrent episodes of upper airway obstruction during sleep leading to hypoxemia and arousal. Anatomical features, such as upper airway narrowing and obesity, contribute to the development of OSA. OSA can be diagnosed based on polysomnography findings, and positive airway pressure therapy is the mainstay of treatment. However, alternative therapies, such as oral appliances or upper airway surgery, can be considered for patients with intolerance. Patients with OSA face perioperative challenges due to difficult airway management, comorbidities, and effects of sedatives and analgesics. Anatomical changes, reduced upper airway muscle tone, and obesity increase the risks of airway obstruction, and difficulties in intubation and mask ventilation. OSA-related comorbidities, such as cardiovascular and respiratory disorders, further increase perioperative risks. Sedatives and opioids can exacerbate respiratory depression and compromise airway patency. Therefore, careful consideration of alternative pain management options is necessary. Although the association between OSA and postoperative mortality remains controversial, concerns exist regarding adverse outcomes in patients with OSA. Understanding the pathophysiology of OSA, implementing appropriate preoperative evaluations, and tailoring perioperative management strategies are vital to ensure patient safety and optimize surgical outcomes.

show abstract

“… 10 12 However, others showed a significant difference in respiratory and cardiovascular complications in patients followed general anaesthesia compared with neuraxial anaesthesia and peripheral nerve blocks. 13 Besides, previous study showed that neither anaesthetic regimen (propofol/remifentanil vs sevoflurane/remifentanil anaesthesia) increased postoperative nocturnal obstructive and hypoxaemic episodes in patients with OSA following general anaesthesia. 11 In contrast, some studies suggested that propofol used alone or in combination with sevoflurane appears to be associated with more oxygen desaturations in children.…”

Section: Introductionmentioning

confidence: 96%

Study protocol for a randomised controlled clinical trial comparing desflurane-based versus propofol-based anaesthesia on postanaesthesia respiratory depression in patients with obstructive sleep apnoea after major abdominal surgery

Yang²,

Zhang³

et al. 2021

BMJ Open

View full text Add to dashboard Cite

IntroductionPatients with obstructive sleep apnoea (OSA) are more sensitive to postanaesthesia respiratory depression. Whether different anaesthetic regimens (intravenous-based or inhalational-based general anaesthesia) affect the postanaesthesia respiratory depression is controversial. Although desflurane has been reported that presents favourable rapid recovery profile in special patients including whom with OSA, the strong clinical evidence of the benefit on postanaesthesia respiratory depression is far from being revealed. This study aims to fill this knowledge gap by investigating the postanaesthesia respiratory depression in postanaesthesia care unit (PACU) in patients with OSA after major abdominal surgery, followed by desflurane-based anaesthesia compared with propofol-based anaesthesia.Methods and analysisEight hundred and fifty-four patients with OSA scheduled for elective major abdominal surgery will be randomly 1:1 assigned to desflurane-based (n=427) or propofol-based anaesthesia (n=427) using a computer-generated randomisation scheme with permuted block size maintained by a centralised randomisation centre. Patients will be assessed before and a consecutive 3 days after their surgery according to the standardised tasks. Demographic data as well as surgical and anaesthesia information will be collected for the duration of the procedure. Incidence of postanaesthesia respiratory depression in PACU as well as anaesthesia recovery, emergence delirium, postoperative nausea and vomiting, rescue analgesia, duration of PACU and hospital stay, and any other adverse events will be assessed at the given study time point. Investigators performing postoperative follow-up are not involved in both anaesthesia implementation and postoperative care.Ethics and disseminationThis study protocol has been approved by the ethics board at Xiang’an Hospital of Xiamen University (XAHLL2019003). The results of this study will be published in a peer-review journal and presented at national conferences as poster or oral presentations. Participants wishing to know the results of this study will be contacted directly on data publication.Trial registration numberChiCTR2000031087.

show abstract

The prevalence of perioperative complications in patients with and without obstructive sleep apnoea: a prospective cohort study

Cited by 6 publications

References 37 publications

Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea

Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea

Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review

Study protocol for a randomised controlled clinical trial comparing desflurane-based versus propofol-based anaesthesia on postanaesthesia respiratory depression in patients with obstructive sleep apnoea after major abdominal surgery

Contact Info

Product

Resources

About