[Perioperative management of severe obstructive sleep apnea hypopnea syndrome].
OBJECTIVE
To investigate the perioperative management of severe obstructive sleep apnea hypopnea syndrome (OSAHS).


METHODS
Fifty-three patients with severe OSAHS received uvulopalatopharyngoplasty with uvula preservation and radiofrequency tongue base reduction. All the patients were treated with automated continuous positive airway pressure (CPAP) for 3-7 days before operation and automated antibiotic therapy administered in the oropharynx, with 24 h ECG monitoring postoperatively. Polysomnography were carried out before and 6 months after surgery.


RESULTS
The preoperative apnea hypopnea index (AHI) and lowest SaO(2) (LSaO(2)) were 58.4-/+5.1/h and 0.650-/+0.059, respectively, which were 15.5-/+3.2/h and 0.864-/+0.064 at 6 months after surgery, respectively, showing significant changes after surgery (P<0.01). Dyspnea occurred in 2 cases after operation, intraoperative bleeding in 1 case, primary bleeding in 2 cases and hypertension crisis in 1 case.


CONCLUSIONS
Severe OSAHS patients are subject to great surgical risk. Application of auto-CPAP before operation can significantly improve the patients' tolerance of surgery and anesthesia, and reduce the surgical risks and preoperative complications.
Li
Run-han
RH
Departments of Otorhinolaryngology, First People's Hospital of Foshan, Foshan 528000, China. lrhan@fsyyy.com
Zeng
Yong
Y
Wang
Yue-jian
YJ
Zhao
Yuan-xin
YX
Chen
Wei-xiong
WX
Yang
Fang
F
D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D010159:Palate / Q000601:surgery*; D019990:Perioperative Care / Q000379:methods*; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D019651:Plastic Surgery Procedures / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery