Anesthetic and postoperative management of the obstructive sleep apnea patient.
Sleep apnea patients pose a challenge for surgeons, anesthesiologists, and surgical facilities as there is increased risk for anesthetic and postoperative complications. Precautions before and after surgery minimize these risks. Screening for sleep apnea should be done for all surgical patients. Safe perioperative management requires judicious use of narcotics and sedating medications, reducing upper airway edema, prevention of aspiration and deep vein thrombosis, blood pressure control, use of positive airway pressure, and proper postoperative monitoring. Although the literature lacks specific recommendations, the guidelines presented in this article are based on more than 20 years of experience and supported by peer-reviewed medical literature.
Mickelson
Samuel A
SA
Advanced Ear Nose & Throat Associates PC, Atlanta, GA 30342, USA. sammickelson@earthlink.net
D000701:Analgesics, Opioid / Q000627:therapeutic use; D000758:Anesthesia / Q000009:adverse effects; D004487:Edema / Q000517:prevention & control; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008991:Monitoring, Physiologic; D010347:Patient Care Planning; D011175:Positive-Pressure Respiration; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D053120:Respiratory Aspiration / Q000517:prevention & control; D012140:Respiratory Tract Diseases / Q000517:prevention & control; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000601:surgery*
D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives