This well researched meta-analysis describes the various complications obstructive sleep apnoea (OSA) patients may acquire after surgery. These American reviewers found that OSA patients after non-upper airway operations, were more like to suffer (compared to non-OSA patients), from the following complications: respiratory complications were significantly more likely to occur in OSA patients (overall OR=2.77 – 95%CI 1.73–4.43). Specifically hypoxemia and the need for prolonged oxygen therapy postoperatively; cardiac complications including dysrhythmias, abnormal heart rate, myocardial infarction and ischemia, hypotension, and congestive heart failure had a OR=1.76 (95%CI 1.16–2.67); neurological complications including delirium, agitation, confusion, and excessive drowsiness had an OR=2.65 (95%CI 1.43–4.92); and the risk of an unplanned ITU admission was OR=2.97 (95%CI 1.90–4.64). The discussion concludes that patients at high risk of OSA need to be screened before undergoing an operation. This will hopefully reduce these stormy postoperative spells, and result in better outcomes for patients, and less sleepless nights for surgeons. Now all we need is a good screening tool! Currently all we have is clinical vigilance with preoperative polysomnography.
Postoperative complications in OSA patients
Reviewed by Vik Veer
Post-operative outcomes in adult obstructive sleep apnea patients undergoing non-upper airway surgery: a systematic review and meta-analysis.
CONTRIBUTOR
Vik Veer
Royal National Throat, Nose & Ear Hospital and Queens Hospital, Romford, UK.
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