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Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review
Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Dental Society of Anesthsiology
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407451/ https://www.ncbi.nlm.nih.gov/pubmed/37559666 http://dx.doi.org/10.17245/jdapm.2023.23.4.179 |
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author | Bae, Eunhye |
author_facet | Bae, Eunhye |
author_sort | Bae, Eunhye |
collection | PubMed |
description | Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA is characterized by recurrent episodes of upper airway obstruction during sleep leading to hypoxemia and arousal. Anatomical features, such as upper airway narrowing and obesity, contribute to the development of OSA. OSA can be diagnosed based on polysomnography findings, and positive airway pressure therapy is the mainstay of treatment. However, alternative therapies, such as oral appliances or upper airway surgery, can be considered for patients with intolerance. Patients with OSA face perioperative challenges due to difficult airway management, comorbidities, and effects of sedatives and analgesics. Anatomical changes, reduced upper airway muscle tone, and obesity increase the risks of airway obstruction, and difficulties in intubation and mask ventilation. OSA-related comorbidities, such as cardiovascular and respiratory disorders, further increase perioperative risks. Sedatives and opioids can exacerbate respiratory depression and compromise airway patency. Therefore, careful consideration of alternative pain management options is necessary. Although the association between OSA and postoperative mortality remains controversial, concerns exist regarding adverse outcomes in patients with OSA. Understanding the pathophysiology of OSA, implementing appropriate preoperative evaluations, and tailoring perioperative management strategies are vital to ensure patient safety and optimize surgical outcomes. |
format | Online Article Text |
id | pubmed-10407451 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Korean Dental Society of Anesthsiology |
record_format | MEDLINE/PubMed |
spelling | pubmed-104074512023-08-09 Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review Bae, Eunhye J Dent Anesth Pain Med Review Article Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA is characterized by recurrent episodes of upper airway obstruction during sleep leading to hypoxemia and arousal. Anatomical features, such as upper airway narrowing and obesity, contribute to the development of OSA. OSA can be diagnosed based on polysomnography findings, and positive airway pressure therapy is the mainstay of treatment. However, alternative therapies, such as oral appliances or upper airway surgery, can be considered for patients with intolerance. Patients with OSA face perioperative challenges due to difficult airway management, comorbidities, and effects of sedatives and analgesics. Anatomical changes, reduced upper airway muscle tone, and obesity increase the risks of airway obstruction, and difficulties in intubation and mask ventilation. OSA-related comorbidities, such as cardiovascular and respiratory disorders, further increase perioperative risks. Sedatives and opioids can exacerbate respiratory depression and compromise airway patency. Therefore, careful consideration of alternative pain management options is necessary. Although the association between OSA and postoperative mortality remains controversial, concerns exist regarding adverse outcomes in patients with OSA. Understanding the pathophysiology of OSA, implementing appropriate preoperative evaluations, and tailoring perioperative management strategies are vital to ensure patient safety and optimize surgical outcomes. The Korean Dental Society of Anesthsiology 2023-08 2023-07-29 /pmc/articles/PMC10407451/ /pubmed/37559666 http://dx.doi.org/10.17245/jdapm.2023.23.4.179 Text en Copyright © 2023 Journal of Dental Anesthesia and Pain Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Bae, Eunhye Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review |
title | Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review |
title_full | Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review |
title_fullStr | Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review |
title_full_unstemmed | Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review |
title_short | Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review |
title_sort | preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407451/ https://www.ncbi.nlm.nih.gov/pubmed/37559666 http://dx.doi.org/10.17245/jdapm.2023.23.4.179 |
work_keys_str_mv | AT baeeunhye preoperativeriskevaluationandperioperativemanagementofpatientswithobstructivesleepapneaanarrativereview |