Perioperative Implementation of Continuous Positive Airway Pressure: A Review of the Considerations

Abstract

OSA patients present unique challenges in the peri-operative period. They routinely require more monitoring, oxygen therapy, unplanned ICU admissions, longer hospital stays, and have more adverse events than healthy counterparts. Some data suggest that perioperative CPAP use is associated with reduced morbidity and mortality of patients with OSA, and yet its application remains inconsistent. This review aims to summarize existing literature on the peri-operative use of CPAP, identify barriers to its implementation, and begin defining an algorithm for the practical application of peri-operative CPAP.

EDITORIAL - Sleep and Anesthesia

“…Continuous Positive Airway Pressure (CPAP) is the golden standard for treatment of patients with OSA, but the method has limitations in the perioperative period. Karan and co-workers summarize the considerations regarding perioperative implementation of CPAP [14]. Opioids are the first line treatment of severe postoperative pain, but opioids decrease respiratory drive and their use is associated with serious postoperative respiratory complications in patients susceptible to their side effects.…”