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Updated: May 17, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Sleep apnea: is routine preoperative screening necessary?
Dmitry Nepomnayshy1, Walid Hesham, Brandon Erickson
1Department of General Surgery and Orthopedic Surgery, Lahey Clinic, Tufts University Medical School, Burlington, MA, USA. dmitry.nepomnayshy@lahey.org
Obesity Surgery
|October 30, 2012
Summary
Routine screening for obstructive sleep apnea (OSA) before bariatric surgery identifies many new cases. However, unscreened obese patients undergoing orthopedic surgery did not show increased complications, questioning the universal need for preoperative OSA screening.
Area of Science:
- Anesthesiology
- Sleep Medicine
- Bariatric Surgery
Background:
- Obstructive sleep apnea (OSA) poses significant perioperative risks, leading many bariatric surgery programs to screen patients.
- Routine OSA screening is less common for obese patients undergoing non-bariatric surgeries.
Purpose of the Study:
- To evaluate the necessity of routine preoperative obstructive sleep apnea screening in morbidly obese patients undergoing surgery.
Main Methods:
- Compared morbidly obese patients undergoing bariatric surgery (screened for OSA) with those undergoing orthopedic lower extremity total joint replacements (TJR) (not screened).
- Recorded and compared cardio-pulmonary complication rates between the two groups.
Main Results:
- Bariatric surgery screening newly diagnosed OSA in 25.5% of patients (42.8% overall incidence).
- Unscreened orthopedic patients had a 6.7% complication rate versus 2.6% in screened bariatric patients.
- This difference in complications was not statistically significant after adjusting for age and comorbidities.
Conclusions:
- Preoperative OSA screening identifies a substantial number of previously undiagnosed OSA cases.
- This study found no increased perioperative cardiopulmonary complications in unscreened morbidly obese orthopedic surgery patients.
- Further randomized trials are needed to confirm the utility and cost-effectiveness of routine OSA screening for all morbidly obese surgical patients.
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