A study published Online First in one of the JAMA journals, Archives of Otolaryngology – Head & Neck Surgery, reveals that even though patients who undergo surgery for obstructive sleep apnea (a sleep disorder characterized by pauses in breathing) may not require admission to an intensive care unit (ICU) after surgery, they should still be closely monitored.
As individuals suffering with sleep apnea are at higher risk for airway compromise after surgery, surgical procedures were usually considered dangerous and potentially fatal if the patient was not closely monitored.
A retrospective review of 487 individuals with obstructive sleep apnea (OAS) was conducted by Kenny P. Pang, F.R.C.S.Ed., F.R.C.S.I. (OTO), of the Pacific Sleep Center, Singapore, and colleagues. Each of the patients had undergone surgical procedures between January 2007 to May 2010. Multilevel OSA surgery included tongue, nasal and palate procedures. According to the researchers the overall complication rate was 7.1%.
The researchers said:
“Patients with OSA typically have small retrognathic mandibles (lower jaw( with difficult airways and, hence, present as difficult intubations to the anesthesiologists. In addition, respiratory depression from anesthetic agents like muscle relaxants and narcotics are well documented in these patients.”
The researchers highlight that although admission to the ICU after surgery may not be required for all patients with OSA, all patients should still be closely monitored for at least 3 hours after surgery in the recovery or high-dependency area (step-down care from ICU).
The researchers conclude:
“In conclusion, we strongly recommended that the clinician manage the patient with OSA with caution and prudence, with the understanding that these patients have a higher risk of airway compromise and respiratory depression intraoperatively and postoperatively.”
Written by Grace Rattue