Respiratory perioperative management of patients with obstructive sleep apnea

Journal of Intensive Care Medicine
Jahan PorhomayonAli A El-Solh

Abstract

Obstructive sleep apnea (OSA) has become a major public health problem in the United State and Europe. However, perioperative strategies regarding diagnostic options and management of untreated OSA remain inadequate. Preoperative screening and identification of patients with undiagnosed OSA may lead to early perioperative interventions that may alter cardiopulmonary events associated with surgery and anesthesia.(1) Hence, clinicians need to become familiar with the preoperative screening and diagnosis of OSA. Perioperative management of a patient with OSA should be modified and may include regional anesthesia and alternative analgesic techniques such as nonsteroidal anti-inflammatory drugs that may reduce the need for systemic opioids. Additionally, supplemental oxygen and continuous pulse oximetry monitoring should be utilized to maintain baseline oxygen saturation. Postoperatively patients should remain in a semi-upright position and positive pressure therapy should be used in patients with high-risk OSA.

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Citations

Sep 10, 2016·Anesthesiology Research and Practice·Diwakar D BalachandranKaty E French
Apr 25, 2018·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Phillip HuyettEric W Wang
Mar 24, 2016·F1000Research·Sebastian ZarembaMatthias Eikermann
Sep 12, 2018·Global Spine Journal·Andrew S ChungNorman Chutkan

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