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Canadian Journal of Anesthesia 49:A98 (2002)
© Canadian Anesthesiologists' Society, 2002

Abstracts - Tuesday June 25th 2002 1030 - 1230

POSTOPERATIVE COMPLICATIONS IN OBSTRUCTIVE SLEEP APNEA PATIENTS

Paul Serowka, MD, Kim Turner, MD FRCPC, Brian Milne, MD FRCPC and Ted Ashbury, MD FRCPC

Department of Anesthesiology, Queen's University, 76 Stuart Street, Kingston, Ontario, K7L 2V7

INTRODUCTION

Obstructive Sleep Apnea Syndrome (OSAS) affects up to 4% of men, 2% of women1. OSAS patients are vulnerable to respiratory complications postoperatively2 (postop). The objective of this review was to examine the type and the rate of postop complications and, the role of Continuous Positive Airway Pressure (CPAP) treatment postop.

METHODS

Following Research Ethics Board approval, chart review of all patients with OSAS who underwent surgery between 1996-2000 at Kingston General Hospital was completed. Patients with a diagnosis of OSAS documented by a sleep study available for review, or preop use of CPAP and monitored postop were included. Data collected included: sleep study parameters, lowest SaO2 (LSat), apnea/hypopnea index (AHI), Body Mass Index (BMI), surgical procedure, anesthetic time (T), ASA class, lowest postop SaO2 (LSat) recorded, respiratory complications requiring airway intervention, and myocardial infarction (MI). Data were analyzed using ANOVA and chi-square.

RESULTS

48 patients were identified (12 females, 36 males). Mean and Standard Deviation values were: age 59.2(±14.6)yr, BMI 33.8(±8.3)kg/m{approx}, sleep study LSat 79.9(±14.0)%, postop LSat 90.2(±7.0)%, AHI 25.4(±34.7), and anesthetic T 182.4(±88.8)min.

AHI (p=0.026), BMI (p=0.003), and anesthetic T (p=0.004) were statistically different between groups I, II, and III. There was no statistical difference in: sleep study LSat, type of surgery, and ASA class in groups I, II, and III. No patient required airway intervention and none had an MI.


Group Postop LSat No Postop CPAP Postop CPAP Total
I. SaO2 >90% 10 (62%) 18 (56%) 28 (58%)
II. SaO2 85-90% 6 (38%) 9 (28%) 15 (31%)
III. SaO2 < 85% 0 (0%) 5 (16%) 5 (11%)
Total 16 (33%) 32 (67%) 48

DISCUSSION

All cases of severe desaturation (SaO2<85%) occurred in the CPAP group. Use of CPAP in the post-op period did not prevent post-op desaturation in our patient population. AHI, BMI, and anesthetic T may be predictors of postop desaturation in OSAS population.

REFERENCES

1 NEJM 328(17):1230–1235

2 Can J Anesth 42:599–616





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