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Published on: December 6, 2016
Pediatric obstructive sleep apnea: Preoperative and neurocognitive considerations for perioperative management
Arvind Chandrakantan1,2, Mary F Musso2,3, Thomas Floyd4,5,6
1Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Houston, TX, USA.
Insights
Obstructive sleep apnea (OSA) in children impacts behavior and cognition. Early diagnosis and treatment, like adenotonsillectomy, are crucial for managing risks and improving outcomes.
Area of Science:
- Pediatric medicine
- Sleep medicine
- Neurology
Background:
- Obstructive sleep apnea (OSA) affects up to 7.5% of children.
- OSA is linked to behavioral and neurocognitive deficits.
- Timely intervention is vital to mitigate these effects.
Purpose of the Study:
- To outline the perioperative and neurocognitive risks associated with pediatric OSA.
- To assist healthcare providers in managing pediatric OSA patients.
Main Methods:
- Review of existing literature on pediatric OSA.
- Analysis of risks and benefits of treatment options.
Main Results:
- Adenotonsillectomy is the primary surgical treatment for pediatric OSA.
- Surgical timing decisions involve balancing procedural risks against patient benefits.
- Pediatric OSA presents significant perioperative and neurocognitive challenges.
Conclusions:
- Effective management of pediatric OSA requires careful consideration of treatment risks and benefits.
- Understanding perioperative and neurocognitive sequelae is key for optimal patient care.
- Prompt diagnosis and treatment of pediatric OSA can halt or reverse negative changes.
Abstract:
Obstructive sleep apnea (OSA) affects up to 7.5% of the pediatric population and is associated with a variety of behavioral and neurocognitive sequelae. Prompt diagnosis and treatment is critical to halting and potentially reversing these changes. Depending on the severity of the OSA and comorbid conditions, different treatment paradigms can be pursued, each of which has its own unique risk:benefit ratio. Adenotonsillectomy is first-line recommended surgical treatment for pediatric OSA. However, it carries its own perioperative risks and the decision regarding surgical timing is therefore made in the context of procedural risk versus patient benefit. This article presents the seminal perioperative and neurocognitive risks from pediatric OSA to aid with perioperative management.
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