Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome.
BACKGROUND
Patients with STOP-BANG score >3 have a high risk of Obstructive sleep apnea. The aim of this study was to evaluate early postoperative respiratory complications in adults with STOP-BANG score >3 after general anesthesia.


METHODS
This is a prospective double cohort study matching 59 pairs of adult patients with STOP-BANG score >3 (high risk of obstructive sleep apnea) and patients with STOP-BANG score <3 (low risk of obstructive sleep apnea), similar with respect to gender, age and type of surgery, admitted after elective surgery in the Post-Anaesthesia Care Unit in May 2011. Primary outcome was the development of adverse respiratory events. Demographics data, perioperative variables, and postoperative length of stay in the Post-Anesthesia Care Unit and in hospital were recorded. The Mann-Whitney test, the chi-square test and the Fisher exact test were used for comparisons.


RESULTS
Subjects in both pairs of study subjects had a median age of 56 years, including 25% males, and 59% were submitted to intra-abdominal surgery. High risk of obstructive sleep apnea patients had a higher median body mass index (31 versus 24kg/m(2), p<0.001) and had more frequently co-morbidities, including hypertension (58% versus 24%, p<0.001), dyslipidemia (46% versus 17%, p<0.001) and insulin-treated diabetes mellitus (17% versus 2%, p=0.004). These patients were submitted more frequently to bariatric surgery (20% versus 2%, p=0.002). Patients with high risk of obstructive sleep apnea had more frequently adverse respiratory events (39% versus 10%, p<0.001), mild to moderate desaturation (15% versus 0%, p=0.001) and inability to breathe deeply (34% versus 9%, p=0.001).


CONCLUSIONS
After general anesthesia high risk of obstructive sleep apnea patients had an increased incidence of postoperative respiratory complications.
Department of Anaesthesiology, Centro Hospitalar de São João, Porto, Portugal.
Daniela
D
Xará
Department of Anaesthesiology, Centro Hospitalar de São João, Porto, Portugal.
Júlia
J
Mendonça
Department of Anaesthesiology, Centro Hospitalar de São João, Porto, Portugal.
Helder
H
Pereira
Department of Anaesthesiology, Centro Hospitalar de São João, Porto, Portugal.
Alice
A
Santos
Department of Anaesthesiology, Centro Hospitalar de São João, Porto, Portugal; Anaesthesiology and Perioperative Care Unit, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Surgical Department of Faculty of Medicine, University of Porto, Portugal. Electronic address: fernando.abelha@gmail.com.
Fernando José
FJ
Abelha
D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000209:etiology*; D012306:Risk; D020181:Sleep Apnea, Obstructive / Q000150:complications*
Apneia obstrutiva do sono; Desfecho no pós-operatório; Eventos respiratórios; Obstructive sleep apnea; Postoperative outcome; Respiratory events