Perioperative management of patients with obstructive sleep apnea : Update on the practice guidelines of the American Society of Anesthesiologists Task Force.

This article gives a summary of the recommended approach for the perioperative treatment of patients with OSA given in the 2014 guidelines. PMID: 24851836 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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A 40-year-old man was treated with tonsillectomy and underwent early surgical exploration because of bleeding. Postoperative bleeding complications were treated with bronchoscopy. In addition to obesity, normal thyroid function, type 2 diabetes mellitus, and current tobacco abuse with severe obstructive sleep apnea syndrome, biochemistry revealed severe hypercholesterolemia (total cholesterol 572 mg/dL) and hypertriglyceridemia (1,220 mg/dL). During the postoperative period, low doses of propofol (up to 2 mg/kg/h for 10 hours), along with remifentanil (up to 0.0016 mg/kg/h for 20 hours), midazolam, and tramadol, were neede...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
A 72-year-old, 94-kg, 173-cm man with hypertension, diabetes mellitus, obstructive sleep apnea, and a family history of coronary artery disease presented to the authors ’ preoperative evaluation clinic before an elective carpal tunnel release. An electrocardiogram obtained in the clinic showed previously undocumented atrial flutter. The hand surgery was postponed; the patient was referred to the electrophysiology service for further evaluation. He subsequently un derwent a radiofrequency ablation, but then developed recurrent paroxysmal atrial fibrillation after the procedure.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Diagnostic Dilemma Source Type: research
Purpose of review Ambulatory surgery is the standard for the majority of pediatric surgery in 2019 and adenotonsillectomy is the second most common ambulatory surgery in children so it is an apt paradigm. Preparing and managing these children as ambulatory patients requires a thorough understanding of the current literature. Recent findings The criteria for undertaking pediatric adenotonsillectomy on an ambulatory basis, fasting after clear fluids, postoperative nausea and vomiting (PONV), perioperative pain management and discharge criteria comprise the themes addressed in this review. Summary Three criteria deter...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Claude Meistelman Source Type: research
Purpose of review Although both cost and patient preference tend to favor the office-based setting, one must consider the hidden costs in managing complications and readmissions. The purpose of this review is to provide an update on safety outcomes of office-based procedures, as well as to identify common patient-specific factors that influence the decision for office-based surgery or impact patient outcomes. Recent findings Office-based anesthesia (OBA) success rates from the latest publications of orthopedic, plastic, endovascular, and otolaryngologic continue to improve. A common thread among these studies is the a...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Claude Meistelman Source Type: research
This article presents a super obese patient (BMI 57 kg/m2) with drug-refractory epilepsy and obstructive sleep apnea who underwent left anterior temporal lobectomy through awake craniotomy to preserve language and memory, using warmed humidified high flow nasal cannula (HFNC) oxygen therapy. Awake craniotomy was facilitated by the use of HFNC, which proved essential to prevent airway collapse by creating continuous positive airway pressure through high flow and facilitated intraoperative neurologic language and memory testing while maintaining adequate oxygenation. PMID: 31686115 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
AbstractPerioperative complications related to obstructive sleep apnea still occur despite the use of partial pressure end-tidal CO2\(\left( {{{\text{P}}_{{\text{ETC}}{{\text{O}}_2}}}} \right)\) and pulse oximetry. Airway obstruction can complicate propofol sedation and a novel monitor combining mandibular movement analysis with capnography may facilitate its detection. Patients scheduled for sleep endoscopy were recruited and monitored with standard monitoring,\({{\text{P}}_{{\text{ETC}}{{\text{O}}_2}}},\) and Jaw Activity (JAWAC) mandibular movement sensors. A post hoc analysis investigated airway obstruction prediction ...
Source: Journal of Clinical Monitoring and Computing - Category: Information Technology Source Type: research
Abstract Obstructive Sleep Apnea is characterized by interrupted breathing that leads to cardiovascular sequelae including chronic hypertension that can persist into waking hours. Chronic intermittent hypoxia, which models the hypoxemia associated with sleep apnea, is sufficient to cause a sustained increase in blood pressure that involves the central nervous system. The median preoptic nucleus (MnPO) is an integrative forebrain region that contributes to blood pressure regulation and neurogenic hypertension. The MnPO projects to the paraventricular nucleus (PVN), a pre-autonomic region. We hypothesized that pathw...
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Tags: Am J Physiol Heart Circ Physiol Source Type: research
PMID: 31624879 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research
AbstractPurposeSeverity of hypoxemic events resulting from obstructive sleep apnea (OSA) is correlated with increased risk of complications and sudden death. We studied the use of a peripheral transcutaneous electrical stimulus (TES) on the magnitude and duration of sleep apnea associated hypoxemia in postoperative patients at high risk for OSA.MethodsIn this randomized, double-blind, controlled, single-centre trial, 106 adult patients undergoing elective surgery who were at medium to high risk for OSA (sleep apnea clinical scores of 18 –35) were randomized to either TES (active stimulus group,n = 53) or control (non...
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research
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