Strategies in postoperative analgesia in the obese obstructive sleep apnea patient.
OBJECTIVE
Obstructive sleep apnea (OSA) has become an epidemic worldwide, and OSA patients frequently present for surgery. Comorbidities such as cardiovascular disease, diabetes, hypertension, stroke, gastrointestinal disorder, metabolic syndrome, chronic pain, delirium, and pulmonary disorder increase the perioperative risk for OSA patients.


METHODS
This is a narrative review of the impact of sedative and analgesic therapy on the intraoperative and postoperative course of an obese OSA patient.


RESULTS
An understanding of postoperative complications related to OSA and drug interactions in the context of opioid and nonopioid selection may benefit pain practitioner and patients equally.


CONCLUSIONS
Management of acute postoperative pain in OSA patient remains complex. A comprehensive strategy is needed to reduce the complications and adverse events related to administration of analgesics and anesthetics.
Departments of *Anesthesiology, Division of Critical Care Medicine §Medicine, Division of Pulmonary, Critical Care, and Sleep, Medicine ∥Anesthesiology, Division of Cardiothoracic Anesthesia and Pain Medicine, VA Western New York Healthcare System, Buffalo School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY †Division of Anesthesia and Critical Care Medicine, VA Boston Healthcare System, Boston University School of Medicine, West Roxbury ‡Department of Anesthesiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Jahan
J
Porhomayon
Kay B
KB
Leissner
Ali A
AA
El-Solh
Nader D
ND
Nader
D000700:Analgesics / Q000627:therapeutic use*; D006801:Humans; D009765:Obesity / Q000150:complications / Q000601:surgery*; D010149:Postoperative Pain / Q000188:drug therapy*; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000601:surgery*
D000700:Analgesics