[Tracheotomy or planned prolonged intubation after surgery for patients with OSAS]

Area of Science:

• Anesthesiology and Perioperative Medicine
• Otolaryngology
• Sleep Medicine

Background:

• Obstructive sleep apnea syndrome (OSAS) and obesity independently increase postoperative complication risks.
• Expert opinions raised questions regarding standard surgical practices for OSAS patients.

Purpose of the Study:

• To determine if prolonged intubation or tracheotomy are routine for OSAS patients undergoing surgery.
• To assess current clinical practices and literature evidence for these interventions.

Main Methods:

• Comprehensive literature search across major databases (PubMed, Embase, Cochrane, etc.).
• Nationwide survey of 78 German otorhinolaryngology departments.

Main Results:

• Most ENT departments do not perform planned postoperative prolonged intubation after uncomplicated surgery.
• No surveyed department routinely performs tracheotomy for OSAS patients.
• Standard practice for OSAS and obese patients undergoing two-level surgery involves intubation and monitoring without ventilation.

Conclusions:

• Prolonged intubation and tracheotomy are not standard procedures for OSAS patients with obesity post-uncomplicated surgery.
• Current evidence does not support routine use of these invasive measures.