Predictive factors of immediate postoperative complications after uvulopalatopharyngoplasty.
OBJECTIVE
This study was performed to assess the relationships between polysomnographic data, including the level of obstruction inducing apnea, and immediate postoperative complications or oxygen saturation in patients who had undergone uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea syndrome (OSAS).


METHODS
Retrospective study.


METHODS
Using the data of 90 patients with a polysomnography-confirmed diagnosis of OSAS who had undergone UPPP surgery with/without tonsillectomy under general anesthesia, we determined apnea-hypopnea indices (AHI), preoperative lowest arterial saturation (LSAT-PREOP) levels, percentages of obstruction at the upper level of the uvula during apnea (AL-U), need for an airway in the postanesthesia care unit (PACU) or during the first postoperative night in a ward (POPN1), LSAT- PACU, LSAT-POPN1, and the incidence of postoperative bleeding or other complications.


RESULTS
Postoperative complications developed in 19 (21.1%) of the 90 patients, airway-related complications in 5 (5.6%), oxygen desaturation in 8 (8.9%), excessive or recurrent bleeding in 7 (7.8%), and a postoperative electrocardiogram change in 1(1.1%). Patients with postoperative complications had higher AHI (68.1 vs. 49.3, P = .008), lower LSAT-PREOP (71.1 vs. 77.8, P = .012), and lower AL-U (24.2 vs. 57.4, P = .005) than those without. After UPPP surgery, LSAT-POPN1 improved more than LSAT-PREOP (94.4 vs. 76.2%, P = .03), and LSAT-POPN1 correlated with LSAT-PREOP (r = 0.274, P = .014) and AL-U (r = 0.286, P = .046).


CONCLUSIONS
This study shows that immediate postoperative complications and oxygen saturation are associated with OSAS severity and the level of obstruction, inducing apnea in those who have undergone UPPP for OSAS.
Kim
Jie Ae
JA
Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Lee
Jeong Jin
JJ
Jung
Hae Hyuk
HH
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D010159:Palate / Q000601:surgery; D010614:Pharynx / Q000601:surgery; D017286:Polysomnography; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D014609:Uvula / Q000601:surgery