Preoperative Screening and Assessment of Adult Patients With Obstructive Sleep Apnea (original) (raw)
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Anesthesia and analgesia, 2016
The purpose of the Society of Anesthesia and Sleep Medicine guideline on preoperative screening and assessment of patients with obstructive sleep apnea (OSA) is to present recommendations based on the available clinical evidence on the topic where possible. As very few well-performed randomized studies in this field of perioperative care are available, most of the recommendations were developed by experts in the field through consensus processes involving utilization of evidence grading to indicate the level of evidence upon which recommendations were based. This guideline may not be appropriate for all clinical situations and all patients. The decision whether to follow these recommendations must be made by a responsible physician on an individual basis. Protocols should be developed by individual institutions taking into account the patients' conditions, extent of interventions and available resources. This practice guideline is not intended to define standards of care or repr...
Obstructive Sleep Apnea: Preoperative Screening and Postoperative Care
Journal of the American Board of Family Medicine : JABFM
The incidence of obstructive sleep apnea (OSA) has reached epidemic proportions, and it is an often unrecognized cause of perioperative morbidity and mortality. Profound hypoxic injury from apnea during the postoperative period is often misdiagnosed as cardiac arrest due to other causes. Almost a quarter of patients entering a hospital for elective surgery have OSA, and >80% of these cases are undiagnosed at the time of surgery. The perioperative period puts patients at high risk of apneic episodes because of drug effects from sedatives, narcotics, and general anesthesia, as well as from the effects of postoperative rapid eye movement sleep changes and postoperative positioning in the hospital bed. For adults, preoperative screening using the STOP or STOP-Bang questionnaires can help to identify adult patients at increased risk of OSA. In the pediatric setting, a question about snoring should be part of every preoperative examination. For patients with known OSA, continuous posit...
Anesthesia and analgesia, 2018
The purpose of the Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea (OSA) is to present recommendations based on current scientific evidence. This guideline seeks to address questions regarding the intraoperative care of patients with OSA, including airway management, anesthetic drug and agent effects, and choice of anesthesia type. Given the paucity of high-quality studies with regard to study design and execution in this perioperative field, recommendations were to a large part developed by subject-matter experts through consensus processes, taking into account the current scientific knowledge base and quality of evidence. This guideline may not be suitable for all clinical settings and patients and is not intended to define standards of care or absolute requirements for patient care; thus, assessment of appropriateness should be made on an individualized basis. Adherence to this guideline cannot guarant...
OBSTRUCTIVE SLEEP APNEA: PART I. DIAGNOSIS AND EVALUATION
Obstructive sleep apnea (OSA) is a common disorder that is characterized by repetitive partial or complete cessation of airflow, associated with oxyhemoglobin desaturation and increased effort to breath. Patients with undiagnosed sleep apnea represent a major public health problem. Dental professionals have a unique doctor patient relationship that can help them in recognizing the sleep disorder and co-managing the patients along with a physician or a sleep-specialist. This article discusses the etiology and pathogenesis, clinical features and risk factors, consequences, diagnosis and evaluation of Obstructive sleep apnea.The Greek word apnea means breathless or loss of breath. 1 Sleep-disordered breathing (SDB) encompasses a heterogeneous group of sleep-related disorders that are characterized by abnormal pauses in breathing during sleep. There are two major types of SDB: obstructive sleep apnea (OSA) and central sleep apnea (CSA). Despite the difference in the actual cause of each type, in both cases, people with untreated sleep apnea stop breathing repeatedly during their sleep. Of the two types of sleep apneas characterized, OSA is the most common type, constituting greater than 85% of all cases of SBD; CSA is far less common. 2 OSA is caused by a physical blockage of the airway; it results from airflow obstruction secondary to upper airway collapse or anatomic airway obstruction, even though the respiratory effort is still present. In the case of CSA, the
Obstructive Sleep Apnea: A Review Article
2021
Obstructive sleep apnea is characterized by repetitive episodes of complete or partial collapse of the upper airway during sleep. Prevalence of obstructive sleep apnea is favored in men more than woman with a ratio of 2-4:1. Risk factors include nasal obstruction, obesity, gender, craniofacial anatomy, and smoking. Reoccurring symptoms, such as daytime sleepiness and irregular snoring have lead scientists and doctors to further find appropriate means of diagnosis. Polysomnography is proved to be the golden-standard method for diagnosing obstructive sleep apnea. Other diagnostic tools include taking a home apnea test. Positive airway pressure and oral appliances are the two most common noninvasive devices used to treat obstructive sleep apnea. Surgical procedures, like uvulopalatopharyngoplasty and maxillomandibular advancement are the most effective surgeries, especially in severe cases. Obstructive sleep apnea also arises complications and side effects that do not only affect the p...
Perioperative Management of Obstructive Sleep Apnea
CHEST Journal, 2010
Obstructive sleep apnea (OSA) is the most common breathing disorder, with a high prevalence in both the general and surgical populations. OSA is frequently undiagnosed, and the initial recognition often occurs during medical evaluation undertaken to prepare for surgery. Adverse respiratory and cardiovascular outcomes are associated with OSA in the perioperative period; therefore, it is imperative to identify and treat patients at high risk for the disease. In this review, we discuss the epidemiology of OSA in the surgical population and examine the available data on perioperative outcomes. We also review the identifi cation of high-risk patients using clinical screening tools and suggest intraoperative and postoperative treatment regimens. Additionally, the role of continuous positive airway pressure in perioperative management of OSA and a brief discussion of ambulatory surgery in patients with OSA is provided. Finally, an algorithm to guide perioperative management is suggested.