Potential complications of obstructive sleep apnea in patients undergoing gastric bypass surgery.
Patients with morbid obesity undergoing gastric bypass surgery present many unique challenges to the healthcare team. Obstructive sleep apnea (OSA) is a common comorbidity in the postoperative gastric bypass patient. The complexity in the management of these patients during and after anesthesia is immense. Anesthetic agents and analgesics increase the severity of symptoms of OSA. Systemic opioid administration depresses the respiratory drive and decreases oxygen saturation. In addition, normal muscle hypotonia during rapid eye movement sleep increases the chance of respiratory complications during the initial postoperative period. Continuous positive airway pressure can effectively treat sleep apnea in the postoperative gastric bypass patient. There are concerns that pressurized air can inflate the stomach and intestines and result in the disruption of the anastomoses of the gastric bypass patient. If weight loss is sufficient, it can lead to an improvement or even cure of symptoms of OSA.
Deutzer
Juergen
J
Scripps Mercy Hospital, San Diego, CA 92103, USA. Deutzer.Juergen@scrippshealth.org
D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D045422:Continuous Positive Airway Pressure; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
D000701:Analgesics, Opioid