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Pediatric obstructive sleep-disordered breathing and anesthetic considerations

Yaqi Hu1, Samantha Smith2, Alice T Coombs1

  • 1Department of Anesthesiology, Virginia Commonwealth University, Richmond, Virginia.

Current Opinion in Anaesthesiology
|June 19, 2025
PubMed

Insights

Pediatric obstructive sleep-disordered breathing (oSDB) can lead to neurocognitive issues and perioperative complications. Anesthesia providers need to understand oSDB pathophysiology and current guidelines for optimal patient care.

Area of Science:

  • Anesthesiology
  • Pediatric Pulmonology
  • Sleep Medicine

Background:

  • Obstructive sleep-disordered breathing (oSDB) is increasingly recognized in pediatric populations.
  • oSDB is associated with significant neurocognitive deficits and developmental challenges.
  • The condition poses unique risks during the perioperative period.

Purpose of the Study:

  • To review the pathophysiology of pediatric obstructive sleep-disordered breathing (oSDB).
  • To examine the implications of oSDB for anesthesia.
  • To provide recommendations for perioperative care in children with oSDB.

Main Methods:

  • Literature review of pathophysiology, anesthetic management, and perioperative care for pediatric oSDB.
  • Synthesis of current evidence and guidelines.
  • Expert consensus on best practices.

Main Results:

  • Pediatric patients with oSDB exhibit neurocognitive impairments.
  • These patients face an elevated risk of perioperative complications, including respiratory events.
  • Understanding oSDB pathophysiology is crucial for safe anesthetic management.

Conclusions:

  • Anesthesia providers must possess a comprehensive understanding of pediatric oSDB pathophysiology.
  • Staying updated on current perioperative care recommendations is essential.
  • This knowledge is vital to minimize adverse events in pediatric patients with oSDB.
Abstract

Keywords:
adenotonsillectomypediatric obstructive sleep apneaperioperative respiratory adverse events

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