[Perioperative management of uvulopalatopharyngoplasty for the obstructive sleep apnea patient].
The perioperative courses of 10 patients with obstructive sleep apnea syndrome who underwent uvulopalatopharyngoplasty were reported. No hypnotic was administered at night before operation. Premedication consisted of atropine 0.5 mg, meperidine 35 mg, given i.m. 1 hr prior to surgery. No patients developed respiratory depression after premedication. General anesthesia was induced with iv thiopental, and succinylcholine was given to facilitate tracheal intubation. Airway management was technically difficult in all patients. Anesthesia was maintained with N2O-O2-enflurane under controlled ventilation. At the end of the surgery the insertion of a nasopharyngeal airway was performed for the prevention of airway obstruction. In 8 patients it was possible to remove the airway in the next morning. Dexamethasone was administered 3 times to reduce pharyngeal edema during perioperative period. Trachea was extubated when the patient was fully awake and alert. Perioperatively the following points are important in the management of uvulopalatopharyngoplasty. 1. Assessment of airway and the method of airway control. 2. Reduction of pharyngeal edema. 3. Using caution against the postoperative hemorrhage. 4. Avoidance of sedation. 5. Close observation extending into the postoperative period.
Andoh
K
K
Department of Anesthesiology, Sendai Red Cross Hospital.
Shima
T
T
Tajima
T
T
Hoshi
K
K
Hashimoto
Y
Y
D000328:Adult; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010159:Palate / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D012891:Sleep Apnea Syndromes / Q000601:surgery*