Perioperative risks and their management in patients with sleep-related breathing disorders

Patients with sleep apnea syndromes pose several challenges to the anaesthetist. These are resulting from comorbidity, but mainly from special requirements for pre-, intra- and postoperative management. Frequently, the diagnosis is not known or not diagnosed adequately, making careful preoperative evaluation of the patient by the anaesthetist imperative to identify patients at risk. Besides cardiovascular complications, problems with airway maintenance must be expected, calling for adequate planning. Several general considerations for anaesthesiologic management should be taken into account. The use of short acting pharmacologic agents is recommended to reduce the risk of postoperative episodes of hypoxia following general anaesthesia. Close cooperation of anaesthesia and the surgical specialties involved is the basis for safe management of patients with sleep related syndromes.