Obstructive sleep apnea and sedation in the endoscopy suite.
Patients with obstructive sleep apnea are at risk of mortality and morbidity related to the administration of sedatives, anesthetics, and opioids. Commonly employed sedatives and analgesics promote pharyngeal collapse and alter normal respiratory responses to obstruction and apnea. Literature concerning patients with obstructive sleep apnea undergoing moderate and deep sedation in the endoscopy suite is lacking. The purpose of this article is to provide the reader with a review of normal airway patency, the effects of obstructive sleep apnea on airway patency, and the impact that analgesics and sedatives may impart on the airway of patients with obstructive sleep apnea. The goal of this article is to increase awareness, stimulate discussions within the gastroenterological community, and encourage research regarding sedation in this at-risk population.
Moos
Daniel D
DD
Kearney Anesthesia Associates, Kearney, Nebraska 68847, USA. moosd@charter.net
D000402:Airway Obstruction / Q000209:etiology / Q000517:prevention & control; D000700:Analgesics / Q000009:adverse effects; D016292:Procedural Sedation / Q000009:adverse effects* / Q000379:methods / Q000451:nursing / Q000523:psychology; D004347:Drug Interactions; D016903:Drug Monitoring; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects* / Q000451:nursing; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007821:Laryngeal Muscles / Q000503:physiopathology; D008465:Mechanoreceptors / Q000503:physiopathology; D016343:Monitoring, Intraoperative; D009765:Obesity / Q000150:complications; D010609:Pharyngeal Muscles / Q000503:physiopathology; D010614:Pharynx / Q000503:physiopathology; D017286:Polysomnography; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D012895:Sleep, REM / Q000502:physiology
D000700:Analgesics; D006993:Hypnotics and Sedatives