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Obstructive sleep apnea and bariatric surgical guidelines: summary and update
Christel A L de Raaff1, Nico de Vries2,3,4, Bart A van Wagensveld1
1Department of Surgery, OLVG West.
Current Opinion in Anaesthesiology
|November 28, 2017
Summary
Bariatric surgery patients with obstructive sleep apnea (OSA) require specific perioperative management. Screening for OSA and obesity hypoventilation syndrome (OHS) and implementing precautions like CPAP can reduce complications.
Area of Science:
- Anesthesiology
- Pulmonology
- Bariatric Surgery
Background:
- Obstructive sleep apnea (OSA) is highly prevalent in bariatric surgery patients.
- There is growing interest in optimizing perioperative management for these patients.
Purpose of the Study:
- To summarize the first consensus guideline on perioperative management of OSA in bariatric surgery.
- To provide an update on the latest literature regarding OSA management in this population.
Main Methods:
- Review of the first consensus guideline on perioperative management of OSA in bariatric surgery.
- Update of the newest available literature on the topic.
Main Results:
- Screening for OSA and obesity hypoventilation syndrome (OHS) is recommended for all bariatric patients.
- Intraoperative precautions include preoxygenation, ramped position, CPAP, low tidal volumes, and opioid avoidance.
- Postoperative care involves CPAP therapy and continuous monitoring (e.g., pulse oximetry).
Conclusions:
- Multiple precautions can minimize cardiopulmonary complications and enhance recovery.
- A combination of these procedures offers optimal perioperative care for OSA patients undergoing bariatric surgery.
- Most recommendations rely on expert opinion, highlighting the need for future research.
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