Perioperative management of Obstructive Sleep Apnoea: Present themes and future directions

Author:

Chambers Tom12,Bamber Harry3,Singh Nanak4

Affiliation:

1. Core Anaesthetic Trainee, London School of Anaesthesia

2. Honorary Clinical Fellow, St Bartholomew's Hospital, Bart's Health NHS Trust, London

3. Anaesthetic Trainee, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Wales, UK

4. Consultant Respiratory Physician, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK

Abstract

Purpose of review Obstructive sleep apnoea (OSA) is an increasingly common pathology that all those involved in perioperative care will come across. Patients with the condition present a challenge at many stages along the perioperative journey, not least because many patients living with OSA are unaware of their diagnosis. Key interventions can be made pre, intra-, and postoperatively to improve outcomes. Knowledge of screening tools, diagnostic tests, and the raft of treatment options are important for anyone caring for these patients. Recent findings Recent literature has highlighted the increasing complexity of surgical patients and significant underdiagnosis of OSA in this patient population. Work has demonstrated how and why patients with OSA are at a higher perioperative risk and that effective positive airways pressure (PAP) therapy can reduce these risks, alongside evidencing how best to optimise adherence to therapy, a key issue in OSA. Summary OSA, and particularly undiagnosed OSA, presents a huge problem in the perioperative period. Perioperative PAP reduces the risk of postoperative complications but adherence remains an issue. Bespoke perioperative pathways should be developed to identify and optimise high risk patients, although at present evidence on how best to achieve this is lacking.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Pulmonary and Respiratory Medicine

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