Three Sudden Postoperative Respiratory Arrests Associated with Epidural Opioids in Patients with Sleep Apnea

Am, Ostermeier; Mf, Roizen; Hautkappe, Martin; Pa, Klock; Jm, Klafta

doi:10.1097/00000539-199708000-00037

Cited by 61 publications

(30 citation statements)

References 38 publications

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“…Apneas, particularly those exacerbated by sedation, can potentially induce arrhythmias or even myocardial ischemia. Thus, apnea-hypopneas can potentially produce life-threatening cardiorespiratory complications in a sedated patient with sleep apnea [11,12].…”

Section: Introductionmentioning

confidence: 99%

Does sleep apnea increase the risk of cardiorespiratory complications during endoscopy procedures?

et al. 2010

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Section: Introductionmentioning

confidence: 99%

Does sleep apnea increase the risk of cardiorespiratory complications during endoscopy procedures?

et al. 2010

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“…Epidural analgesia, however, may not eliminate this risk. Respiratory arrest has been reported in those with OSA receiving epidural opioids at 2 to 3 days postoperatively [34].…”

Section: Sedation and Analgesiamentioning

confidence: 99%

Challenges in Pulmonary Risk Assessment and Perioperative Management in Bariatric Surgery Patients

et al. 2007

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Bariatric surgery has serious associated medical comorbidity and procedure-related risks and is, thus, considered an intermediate-to-high-risk non-cardiac surgery. Altered respiratory mechanics, obstructive sleep apnea (OSA), and less often, pulmonary hypertension and postoperative pulmonary embolism are the major contributors to poor pulmonary outcomes in obese patients. Attention to posture and positioning is critical in patients with OSA. Suspected OSA patients requiring intravenous narcotics should be kept in a monitored setting with frequent assessments and naloxone kept at the bedside. Use of reverse Tredelenburg position, preinduction, maintenance of positive end-expiratory pressure, and use of continuous positive airway pressure can help improve oxygenation in the perioperative period.

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“…Obstructive sleep apnea (OSA) is associated with major adverse health outcomes that can be exacerbated in the postoperative setting [1][2][3][4]. In response to reports of adverse postoperative outcomes, various organizations have suggested that hospitals develop specific perioperative management protocols for OSA to improve patient safety [5,6].…”

Section: Introductionmentioning

confidence: 99%

Avoiding adverse outcomes in patients with obstructive sleep apnea (OSA): development and implementation of a perioperative OSA protocol

Bolden

Smith

Auckley

2009

Journal of Clinical Anesthesia

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Three Sudden Postoperative Respiratory Arrests Associated with Epidural Opioids in Patients with Sleep Apnea

Cited by 61 publications

References 38 publications

Does sleep apnea increase the risk of cardiorespiratory complications during endoscopy procedures?

Does sleep apnea increase the risk of cardiorespiratory complications during endoscopy procedures?

Challenges in Pulmonary Risk Assessment and Perioperative Management in Bariatric Surgery Patients

Avoiding adverse outcomes in patients with obstructive sleep apnea (OSA): development and implementation of a perioperative OSA protocol

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