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General Anesthesia: Overview01:24

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Obstructive Sleep Apnea-a Perioperative Risk Factor.

Philipp Fassbender1, Frank Herbstreit, Matthias Eikermann

  • 1Clinic for Anesthesiology and Intensive Care & Essen University Hospital, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, USA, und Universität Duisburg-Essen, Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen.

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Summary
This summary is machine-generated.

Obstructive sleep apnea (OSA) is a significant perioperative risk. OSA patients face increased risks during and after surgery, requiring specialized multidisciplinary care for airway management and postoperative monitoring.

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Area of Science:

  • Anesthesiology and Perioperative Medicine
  • Sleep Medicine
  • Respiratory Medicine

Background:

  • Obstructive sleep apnea (OSA) is a prevalent breathing disorder often overlooked as a perioperative risk factor.
  • OSA is characterized by recurrent upper airway obstruction during sleep, leading to hypoxemia and sympathetic nervous system activation.

Purpose of the Study:

  • To review the perioperative risks and management strategies for patients with obstructive sleep apnea.
  • To highlight the importance of recognizing and managing OSA in the surgical setting.

Main Methods:

  • A selective PubMed search was conducted for articles published up to August 15, 2015, using terms related to sleep apnea and anesthesia/pathophysiology.
  • Guidelines from multiple specialty societies were also considered.

Main Results:

  • An estimated 22% to 82% of surgical patients have OSA, a condition linked to hypertension, heart disease, and heart failure.
  • OSA assessment can be done preoperatively using polysomnography or questionnaires (STOP/STOP-BANG).
  • Patients with OSA are at higher risk for perioperative complications, including ventilation difficulties, airway obstruction, and comorbid condition exacerbations.

Conclusions:

  • OSA management requires a multidisciplinary approach involving anesthesiologists experienced in OSA recognition, airway management, and postoperative care.
  • Further research, including randomized trials, is needed to compare anesthesia modalities for OSA patients regarding postoperative outcomes.