Implications of obstructive sleep apnea syndrome for the perianesthesia nurse

Perianesthesia nurses care for patients who receive anesthesia, sedation, and analgesia. Anesthesia, sedation, and analgesia can adversely affect the patient with obstructive sleep apnea syndrome (OSAS). Increased patient morbidity and mortality have been associated with the perianesthesia management of the patient with OSAS and can potentially impact every phase of the perianesthesia experience. Negative outcomes have been associated with respiratory arrest after the administration of opioid or sedative medications, difficult intubation or failure to intubate, and respiratory obstruction after extubation. It is important for the perianesthesia nurse to identify the implications of OSAS and respond with appropriate patient management strategies. The purpose of this article is to identify perianesthesia implications associated with the patient with formally diagnosed OSAS, patient characteristics that may imply undiagnosed OSAS, and considerations for the management of the patient with OSAS for each phase of the perianesthesia experience. The new ASA practice guidelines developed to assist the practitioner in the decision-making process for the management of this patient population have been incorporated.