Review of multilevel surgery in patients with obstructive sleep apnea

March 19, 2012, JAMA and Archives Journals

Patients with obstructive sleep apnea who undergo surgery for their condition should be closely monitored after their procedures are performed but may not need to be in an intensive care unit, according to a report published Online First by Archives of Otolaryngology – Head & Neck Surgery, one of the JAMA/Archives journals.

Surgical procedures in patients with (a sleep disorder characterized by pauses in breathing) have traditionally been considered dangerous and potentially life threatening if not monitored with caution because these patients are at higher risk for airway compromise postoperatively, the authors write in their study background.

Kenny P. Pang, F.R.C.S.Ed., F.R.C.S.I.(OTO), of the Pacific Sleep Centre, Singapore, and colleagues conducted a retrospective review of 487 patients with (OSA) who underwent surgical procedures from January 2007 to May 2010. Multilevel OSA surgery included nasal, palate and tongue procedures. The overall complication rate was 7.1 percent, the authors note.

"Patients with OSA typically have small retrognathic mandibles (lower jaw) with difficult airways and, hence, present as difficult intubations to the anesthesiologists," the authors comment. "In addition, respiratory depression from anesthetic agents like muscle relaxants and narcotics are well documented in these patients."

The authors note that while routine postoperative admission to the for all patients with OSA might not be necessary, they suggest that all patients with OSA be closely monitored in the recovery or high-dependency area (step-down care from unit) for at least three hours after surgery.

"In conclusion, we strongly recommended that the clinician manage the patient with OSA with caution and prudence, with the understanding that these have a higher risk of airway compromise and respiratory depression intraoperatively and postoperatively," the authors conclude.

More information: Arch Otolaryngol Head Neck Surg. Published online March 19, 2012. doi:10.1001/archoto.2012.130

Related Stories

Recommended for you

Synthetic cannabinoid reduces sleep apnea

November 29, 2017
A synthetic version of a molecule found in the cannabis plant was safe and effective in treating obstructive sleep apnea in the first large, multi-site study of a drug for the sleep disorder funded by the National Institutes ...

Sleeping through the snoring: Researchers identify neurons that rouse the brain to breathe

November 2, 2017
A common and potentially serious sleep disorder, obstructive sleep apnea affects at least one quarter of U.S. adults and is linked to increased risk of diabetes, obesity and cardiovascular disease. In a paper published today ...

Remede system approved for sleep apnea

October 9, 2017
(HealthDay)—The Remede sleep system, an implanted device that treats central sleep apnea by activating a nerve that sends signals to the diaphragm to stimulate breathing, has been approved by the U.S. Food and Drug Administration.

Inflammation may precede sleep apnea, could be treatment target

September 1, 2017
Inflammation is traditionally thought of as a symptom of sleep apnea, but it might actually precede the disorder, potentially opening the door for new ways to treat and predict sleep apnea, according to researchers.

More evidence: Untreated sleep apnea shown to raise metabolic and cardiovascular stress

August 31, 2017
Sleep apnea, left untreated for even a few days, can increase blood sugar and fat levels, stress hormones and blood pressure, according to a new study of sleeping subjects. A report of the study's findings, published in the ...

Sleep patterns contribute to racial differences in disease risk

August 18, 2017
Poor sleep patterns could explain, in part, the differences in the risk of cardiometabolic disease between African-Americans and European-Americans, according to a new study published in Proceedings of the National Academy ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.