Perioperative Management of Obstructive Sleep Apnea

Abstract

Obstructive sleep apnea (OSA) has been linked to a myriad of chronic diseases with physically serious and economically draining consequences. There has been a substantial increase in its prevalence over the last two decades and up to one-quarter of the elective surgical patients have been found to be at high risk for OSA. These patients are at an increased risk for perioperative adverse events such as cardiac and pulmonary complications as well as postoperative delirium. This review addresses the screening methods such as the STOP-Bang questionnaire for the undiagnosed and the preoperative management of the known and at-risk patients. Recommendations for the evaluation of the systemic complications and its management are included. Recent suggestions for the intraoperative management and risk mitigation methods are reviewed, such as the role of regional anesthesia and non-opioid analgesics. Special focuses on postoperative issues such as pain control, oxygenation, positioning, and patient disposition are also included.