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Sleep study indices and early post-tonsillectomy outcomes

Daniel C O'Brien1, Yuti Desai2, Robert T Swanson3

  • 1Department of Otolaryngology-Head and Neck Surgery, 4520 Health Science Center South, PO Box 9200, West Virginia University, Morgantown, WV, USA.

American Journal of Otolaryngology
|July 19, 2018
PubMed

Insights

Children with higher apnea-hypopnea index (AHI) scores from sleep studies experienced longer anesthesia emergence and hospital stays after adenotonsillectomy. These findings can help optimize operating room and hospital workflow.

Area of Science:

  • Pediatric Anesthesiology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Adenotonsillectomy is a common procedure in children.
  • Sleep-disordered breathing is a frequent indication for adenotonsillectomy.
  • Preoperative sleep study findings may impact perioperative outcomes.

Purpose of the Study:

  • To examine the association between preoperative sleep study parameters and anesthesia emergence time, recovery room time, and length of hospital stay in children undergoing adenotonsillectomy.
  • To determine if sleep study indices can predict perioperative resource utilization.

Main Methods:

  • Retrospective case series involving chart review of 314 children aged 1-17 years who underwent adenotonsillectomy.
  • Analysis of preoperative sleep study data including apnea-hypopnea index (AHI) and central apnea index (CAI).
  • Comparison of sleep study findings with in-operating room times, emergence time, recovery room time, and length of stay, controlling for age, gender, and BMI.

Main Results:

  • Higher AHI was significantly associated with longer operating room times, operative times, emergence time, and length of stay (p < 0.001 for emergence time).
  • Central apnea index (CAI) was linked to shorter total operating room times (p = 0.03).
  • AHI, oxygen saturation nadir, CAI, and end-tidal carbon dioxide were not significantly associated with recovery room time.

Conclusions:

  • Preoperative sleep study indices, particularly AHI, are correlated with extended in-operating room times and length of hospital stay following adenotonsillectomy.
  • Sleep study findings can be valuable for predicting and planning operating room and hospital resource allocation.
Abstract

Keywords:
Complications of surgeryObstruction sleep apneaPediatric surgeryTonsillectomy

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