Acute Airway Obstruction after Uvulopalatopharyngoplasty for Obstructive Sleep Apnea Syndrome

Gabrielczyk, M.

doi:10.1097/00000542-198812000-00022

Cited by 29 publications

(3 citation statements)

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“…However, this is the first comparative study to use postoperative objective assessment in the home rather than the subjective assessment of the patient or sleeping partner, which for a variety of reasons may be unreliable. In view of our results and the published reports of serious complications after UPPP 13–15 we feel that LAUP is preferable to UPPP except if the sleep nasendoscopy demonstrated palatal flutter with vibration at the level of the tonsils.…”

Section: Resultsmentioning

confidence: 99%

Uvulopalatopharyngoplasty versus laser assisted uvulopalatoplasty for the treatment of snoring: an objective randomised clinical trial

Osman¹,

Osborne²,

Hill

et al. 2000

Clin Otolaryngol

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This study was designed to evaluate objectively the clinical effectiveness of surgery for snoring and to compare the results of conventional uvulopalatopharyngoplasty (UPPP) and laser assisted uvulopalatoplasty (LAUP) in the treatment of snoring. Patients who had been referred for investigation and treatment of their snoring were randomly allocated to receive either UPPP or LAUP. Forty-seven patients with confirmed palatal flutter had surgery and all of them had a preoperative and postoperative objective assessment of their snoring loudness and duration in the home. The recording device (Snore Box) is simple for the patient to operate, portable with a built in microphone, and able to produce objective results, which can be automatically analysed. Of the 38 patients, who had technically valid recordings, 22 underwent LAUP and 16 UPPP. Overall the mean postoperative Snore Index (SI) was less than the preoperative SI (P < 0.0001), the average difference being 78.2 snores/h. There was no significant difference between the LAUP and UPPP regarding the fall in the SI. This study is the first objective comparative study to demonstrate the effectiveness of snoring surgery.

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Section: Resultsmentioning

confidence: 99%

Uvulopalatopharyngoplasty versus laser assisted uvulopalatoplasty for the treatment of snoring: an objective randomised clinical trial

Osman¹,

Osborne²,

Hill

et al. 2000

Clin Otolaryngol

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“…When inducing general anesthesia during palatal muscle resection (PRM) [6] to treat such OSAS patients, and the maintenance of mask ventilation may be difficult due to the airway obstruction from the reduced pharyngeal muscle tension [7,8], and intubation may be difficult due to the abnormalities of the face or the upper airway [9]. Such a difficult intubation can be the main factor leading to increased morbidity and an increased death rate [10,11].…”

Section: Introductionmentioning

confidence: 99%

The relationship between the predictors of obstructive sleep apnea and difficult intubation

Lee¹,

Lee²,

Kim³

et al. 2011

Korean J Anesthesiol

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BackgroundThe study was performed in order to determine the risk factors for difficult tracheal intubation in obstructive sleep apnea patients.MethodsFor 115 male patients with obstructive sleep apnea syndrome and who were undergoing palatal muscle resection (PMR), we investigated the correlation between their age, height, weight, body mass index (BMI), their Epworth Sleepiness Scale (ESS), their apnea-hypopnea index (AHI), their neck circumference and the difficulty of tracheal intubation.ResultsThe factors significantly related to difficult tracheal intubation in obstructive sleep apnea patients were a high AHI and a large neck circumference. There was no significant correlation between weight, BMI, arterial hypertension, ESS and difficult tracheal intubation in obstructive sleep apnea patients.ConclusionsIn this study, a high AHI and a large neck circumference can predict difficult tracheal intubation in obstructive sleep apnea patients.

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“…The mechanisms for transient elevation of BP in this critical situation are not understood. It is possible that increases in upper airway resistance due to postoperative airway edema or induced by oral breathing may decrease the upper airway area, thereby causing an increase in the frequency of the obstructive respiratory events during sleep (5)(6)(7)(8). These repetitive episodes of apnea often coincide with marked hypoxia, hypercapnia, and arousals during sleep, all of which are known to increase sympathetic nervous outflow (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Transitory increased blood pressure after upper airway surgery for snoring and sleep apnea correlates with the apnea-hypopnea respiratory disturbance index

Araújo

Ouayoun

Poirier

et al. 2003

Braz J Med Biol Res

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A transitory increase in blood pressure (BP) is observed following upper airway surgery for obstructive sleep apnea syndrome but the mechanisms implicated are not yet well understood. The objective of the present study was to evaluate changes in BP and heart rate (HR) and putative factors after uvulopalatopharyngoplasty and septoplasty in normotensive snorers. Patients (N = 10) were instrumented for 24-h ambulatory BP monitoring, nocturnal respiratory monitoring and urinary catecholamine level evaluation one day before surgery and on the day of surgery. The influence of postsurgery pain was prevented by analgesic therapy as confirmed using a visual analog scale of pain. Compared with preoperative values, there was a significant (P < 0.05) increase in nighttime but not daytime systolic BP (119 ± 5 vs 107 ± 3 mmHg), diastolic BP (72 ± 4 vs 67 ± 2 mmHg), HR (67 ± 4 vs 57 ± 2 bpm), respiratory disturbance index (RDI) characterized by apneahypopnea (30 ± 10 vs 13 ± 4 events/h of sleep) and norepinephrine levels (22.0 ± 4.7 vs 11.0 ± 1.3 µg l -1 12 h -1 ) after surgery. A positive correlation was found between individual variations of BP and individual variations of RDI (r = 0.81, P < 0.01) but not between BP or RDI and catecholamines. The visual analog scale of pain showed similar stress levels on the day before and after surgery (6.0 ± 0.8 vs 5.0 ± 0.9 cm, respectively). These data strongly suggest that the cardiovascular changes observed in patients who underwent uvulopalatopharyngoplasty and septoplasty were due to the increased postoperative RDI.

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Acute Airway Obstruction after Uvulopalatopharyngoplasty for Obstructive Sleep Apnea Syndrome

Cited by 29 publications

References 0 publications

Uvulopalatopharyngoplasty versus laser assisted uvulopalatoplasty for the treatment of snoring: an objective randomised clinical trial

Uvulopalatopharyngoplasty versus laser assisted uvulopalatoplasty for the treatment of snoring: an objective randomised clinical trial

The relationship between the predictors of obstructive sleep apnea and difficult intubation

Transitory increased blood pressure after upper airway surgery for snoring and sleep apnea correlates with the apnea-hypopnea respiratory disturbance index

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