Perioperative sleep apnea: a real problem or did we invent a new disease?

Zaremba, Sebastian; Mojica, James; Eikermann, Matthias

doi:10.12688/f1000research.7218.1

Cited by 16 publications

(10 citation statements)

References 174 publications

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“…[ 17 18 19 20 ] The conducted study showed that pain was a unique significant postoperative complication, which was proved by the studies of other scientists. [ 21 22 23 ]…”

Section: Discussionmentioning

confidence: 99%

Perioperative complications of pediatric otorhinolaryngological operations

et al. 2020

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“…[ 17 18 19 20 ] The conducted study showed that pain was a unique significant postoperative complication, which was proved by the studies of other scientists. [ 21 22 23 ]…”

Section: Discussionmentioning

confidence: 99%

Perioperative complications of pediatric otorhinolaryngological operations

et al. 2020

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“…Keeping a patient as upright as possible during induction may help optimize mask ventilation and also help during extubation. This approach may prevent atelectasis, which may be especially important in patients with OSA 24, 25 .…”

Section: Recommendations For Patient Managementmentioning

confidence: 99%

Recent advances in understanding and managing postoperative respiratory problems

et al. 2019

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Postoperative respiratory complications increase healthcare utilization (e.g. hospital length of stay, unplanned admission to intensive care or high-dependency units, and hospital readmission), mortality, and adverse discharge to a nursing home. Furthermore, they are associated with significant costs. Center-specific treatment guidelines may reduce risks and can be guided by a local champion with multidisciplinary involvement. Patients should be risk-stratified before surgery and offered anesthetic choices (such as regional anesthesia). It is established that laparoscopic surgery improves respiratory outcomes over open surgery but requires tailored anesthesia/ventilation strategies (positive end-expiratory pressure utilization and low inflation pressure). Interventions to optimize treatment include judicious use of intensive care, moderately restrictive fluid therapy, and appropriate neuromuscular blockade with adequate reversal. Patients’ ventilatory drive should be kept within a normal range wherever possible. High-dose opioids should be avoided, while volatile anesthetics appear to be lung protective. Tracheal extubation should occur in the reverse Trendelenburg position, and postoperative continuous positive airway pressure helps prevent airway collapse. In combination, all of these interventions facilitate early mobilization.

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“…An additional hurdle includes post-operative pain management, as OSA patients demonstrate decreased pain tolerance post-operatively. This decreased pain tolerance, combined with baseline hypopnea and increased sensitivity to respiratory depression by opioids, makes their post-operative course especially dangerous and complicated [8][9]. Intravenous (IV) opioids are the most commonly used drugs for pain control in the postanesthesia care unit (PACU).…”

Section: Introductionmentioning

confidence: 99%