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"Sleep apnea" narcotic assessment

Justin S Smith, Christopher I Shaffrey, Han Jo Kim, Peter Passias, Themistocles Protopsaltis, Renaud Lafage, Gregory M Mundis, Eric Klineberg, Virginie Lafage, Frank J Schwab, Justin K Scheer, Emily Miller, Michael Kelly, D Kojo Hamilton, Munish Gupta, Vedat Deviren, Richard Hostin, Todd Albert, K Daniel Riew, Robert Hart, Doug Burton, Shay Bess, Christopher P Ames
BACKGROUND: Surgical treatments for adult cervical spinal deformity (ACSD) are often complex and have high complication rates. OBJECTIVE: To assess all-cause mortality following ACSD surgery. METHODS: ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database. Clinical and surgical parameters and all-cause mortality were assessed. RESULTS: Of 123 ACSD patients, 120 (98%) had complete baseline data (mean age, 60...
January 17, 2018: Neurosurgery
Mihaela S Stefan, Nicholas S Hill, Karthik Raghunathan, Xiaoxia Liu, Penelope S Pekow, Stavros G Memtsoudis, Satya Krishna Ramachandran, Peter K Lindenauer
STUDY OBJECTIVES: To examine the relationship of early initiation of noninvasive ventilation (NIV) with postoperative outcomes in patients with obstructive sleep apnea (OSA) undergoing bariatric surgery. METHODS: We included 5,266 patients with OSA undergoing bariatric surgeries at 161 hospitals in the United States. We defined early postoperative NIV as NIV used on the day of or the day after surgery; this could include prophylactic NIV or NIV used for early signs of respiratory deterioration...
November 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Marilyn Moro, Karen Gannon, Kathy Lovell, Margaret Merlino, James Mojica, Matt T Bianchi
PURPOSE: Treatment-emergent central sleep apnea (TECSA), also called complex apnea, occurs in 5%-15% of sleep apnea patients during positive airway pressure (PAP) therapy, but the clinical predictors are not well understood. The goal of this study was to explore possible predictors in a clinical sleep laboratory cohort, which may highlight those at risk during clinical management. METHODS: We retrospectively analyzed 728 patients who underwent PAP titration (n=422 split-night; n=306 two-night)...
2016: Nature and Science of Sleep
Marie-Lou Filiatrault, Jean-Marc Chauny, Raoul Daoust, Marie-Pier Roy, Ronald Denis, Gilles Lavigne
STUDY OBJECTIVE: Opioids are associated with higher risk for ataxic breathing and sleep apnea. We conducted a systematic literature review and meta-analysis to assess the influence of long-term opioid use on the apnea-hypopnea and central apnea indices (AHI and CAI, respectively). METHODS: A systematic review protocol (Cochrane Handbook guidelines) was developed for the search and analysis. We searched Embase, Medline, ACP Journal Club, and Cochrane Database up to November 2014 for three topics: (1) narcotics, (2) sleep apnea, and (3) apnea-hypopnea index...
April 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Jean-Marc Dumonceau, Andrea Riphaus, Florian Schreiber, Peter Vilmann, Ulrike Beilenhoff, Jose R Aparicio, John J Vargo, Maria Manolaraki, Caroline Wientjes, István Rácz, Cesare Hassan, Gregorios Paspatis
No abstract text is available yet for this article.
December 2015: Endoscopy
Roop Kaw, Babak Mokhlesi, Frances Chung, Peter Gay, Norman Bolden, David Hillman
INTRODUCTION: We present the proceedings of the second annual meeting of the Society of Anesthesia and Sleep Medicine. The theme of the meeting was "Anesthesia and Sleep Medicine: What Every Health Professional Needs to Know." DISCUSSION: While upper airway obstruction during sleep and anesthesia received concentrated attention, with particular regard to perioperative assessment and managment of obstuctive sleep apnea, a diversity of issues were raised including: the genetic basis for variations in ventilatory control; shared charactertics of sleep and anesthesia; hazards posed by narcotic use in patients with obstructive sleep apnea (OSA); the respiratory complication that follow surgery in such patients; who amongst them is suitable for ambulatory surgery; and the special circumstances that apply to anesthesia for children with OSA...
December 2013: Sleep & Breathing, Schlaf & Atmung
Pamela Rickbeil, Joyce Simones
This article describes two collaborative paired student-preceptor efforts. One project resulted in the implementation of a hospital-wide oral care protocol, and the second enhanced the admission assessment process for adult patients at risk for respiratory compromise after sedation and/or receipt of narcotic analgesia. Recommendations for staff development are addressed.
March 2012: Journal for Nurses in Staff Development: JNSD
David Wang, Harry Teichtahl, Cathy Goodman, Olaf Drummer, Ronald R Grunstein, Ian Kronborg
INTRODUCTION: Subjects using opioids on a chronic basis have been reported to have a high prevalence of abnormal sleep architecture and central sleep apnea (CSA). The severity of CSA is, in part, related to blood opioid concentration. The aim of this study was to investigate subjective daytime sleepiness and daytime function in patients who are on stable methadone maintenance treatment (MMT) and to assess the possible mechanisms involving abnormal sleep architecture, CSA severity, and blood methadone concentration...
December 15, 2008: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Roop Kaw, Loutfi Aboussouan, Dennis Auckley, Charles Bae, David Gugliotti, Paul Grant, Wael Jaber, Philip Schauer, Daniel Sessler
Bariatric surgery has serious associated medical comorbidity and procedure-related risks and is, thus, considered an intermediate-to-high-risk non-cardiac surgery. Altered respiratory mechanics, obstructive sleep apnea (OSA), and less often, pulmonary hypertension and postoperative pulmonary embolism are the major contributors to poor pulmonary outcomes in obese patients. Attention to posture and positioning is critical in patients with OSA. Suspected OSA patients requiring intravenous narcotics should be kept in a monitored setting with frequent assessments and naloxone kept at the bedside...
January 2008: Obesity Surgery
Michael Friedman, Hsin-Ching Lin, Berk Gurpinar, Ninos J Joseph
OBJECTIVES: To assess subjective and objective improvement after single-stage multilevel minimally invasive treatment for obstructive sleep apnea/hypopnea syndrome (OSAHS). STUDY DESIGN: A retrospective review of a prospective dataset of patients treated in a tertiary care referral center. METHODS: Charts of 145 patients with mild/moderate OSAHS treated with a single-stage multilevel minimally invasive technique were reviewed to abstract pre- and posttreatment symptoms and polysomnographic data...
October 2007: Laryngoscope
Charles C Berry, Polly Moore, Joel E Dimsdale
Sleep researchers invariably struggle with decisions regarding the optimal design for their studies. Whether such studies involve treatment for insomnia, obstructive sleep apnea, or any other sleep disorder, questions arise regarding the respective trade-offs between a parallel group and a crossover design. This study analyzed the variance structure of commonly measured polysomnographic variables in an effort to describe the statistical impact of these alternate designs. The study examined the effects of opioids on sleep and employed multiple crossovers between placebo, MS-contin, and methadone using a double-blind, randomized crossover design...
December 2006: Journal of Sleep Research
B Hartmann, A Junger, J Klasen
The perioperative risk for patients with obstructive sleep apnea syndrome and the optimal anaesthesiological management of these patients have not been well elucidated. The prevalence of obstructive sleep apnea with significant symptoms is estimated to be 4% in men and 2% in women. However, in 80-95% of patients this syndrome is not sufficiently diagnosed. Thus identification of patients at risk and a thorough multidisciplinary diagnostic approach are essential for optimal perioperative management. The risk of perioperative complications, like cardiopulmonary compromise, and difficulties in airway management is elevated...
July 2005: Der Anaesthesist
Mark E Howard, Anup V Desai, Ronald R Grunstein, Craig Hukins, John G Armstrong, David Joffe, Philip Swann, Donald A Campbell, Robert J Pierce
Sleep-disordered breathing and excessive sleepiness may be more common in commercial vehicle drivers than in the general population. The relative importance of factors causing excessive sleepiness and accidents in this population remains unclear. We measured the prevalence of excessive sleepiness and sleep-disordered breathing and assessed accident risk factors in 2,342 respondents to a questionnaire distributed to a random sample of 3,268 Australian commercial vehicle drivers and another 161 drivers among 244 invited to undergo polysomnography...
November 1, 2004: American Journal of Respiratory and Critical Care Medicine
Michael Friedman, Hani Z Ibrahim, Ramakrishnan Vidyasagar, Jonathan Pomeranz, Ninos J Joseph
OBJECTIVE: Patients without tonsils and with Friedman tongue position (FTP) III and IV are poor candidates for uvulopalatopharyngoplasty (UP3). Even when combined with adjunctive hyopharyngeal techniques, results are poor. We assessed a modified uvulopalatoplasty based on a bilateral Z-plasty in treating patients without tonsils who have obstructive sleep apnea/hypopnea syndrome (OSAHS). METHODS: 25 patients treated with a modified technique were matched with 25 patients previously treated with classic UP3...
July 2004: Otolaryngology—Head and Neck Surgery
Michael Friedman, Hani Ibrahim, Sarah Lowenthal, Vidyasagar Ramakrishnan, Ninos J Joseph
OBJECTIVES: The goal of uvulopalatopharyngoplasty (UP3) in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) is to reduce obstruction by eliminating redundant tissue in three areas: the soft palate, tonsils, and pharynx. However, some OSAHS patients may present with tonsil hypertrophy and elongated soft palate without redundant pharyngeal folds. We treated this group of patients with tonsil reduction using radiofrequency coblation combined with uvulopalatoplasty (UP2) using a palatal flap technique without pharyngoplasty...
March 2004: Laryngoscope
Philippe Rombaux, Marc Hamoir, Bernard Bertrand, Genevieve Aubert, Giuseppe Liistro, Daniel Rodenstein
OBJECTIVES: We compared, in a prospective study, the side effects and the postoperative complications of three procedures commonly used for the treatment of primary snoring. METHOD: Forty-nine patients underwent velopharyngeal surgery for primary snoring (17 for uvulopalatopharyngoplasty [UPPP]; 15 for laser-assisted uvulopalatoplasty [LAUP], and 17 for radiofrequency tissue volume reduction [RFTVR]). Preoperative full polysomnographic studies ruled out obstructive sleep apnea syndrome...
December 2003: Laryngoscope
H Teichtahl, A Prodromidis, B Miller, G Cherry, I Kronborg
AIMS: To explore the possibility that stable MMP patients have sleep-disordered breathing (SDB) and abnormal sleep architecture defined by nocturnal sleep stages and sleep efficiency. DESIGN: Observational. SETTING: Regional Methadone Service and sleep disorders laboratory in a university affiliated hospital. Participants and measurements. Ten stable MMP patients and nine normal subjects were assessed clinically and with overnight polysomnography...
March 2001: Addiction
R J Troell, N B Powell, R W Riley, K K Li, C Guilleminault
OBJECTIVES: This study compares the posttreatment discomfort between laser-assisted uvulopalatoplasty (LAUP), uvulopalatopharyngoplasty (UPPP), and radiofrequency volumetric tissue reduction (RFVTR) of the palate through the use of visual analog pain scales and a quantitative assessment of the analgesic medication taken. METHODS: In one group, LAUP (n = 10) or UPPP (n = 9) was used to treat patients' snoring or sleep-disordered breathing (SDB), and the other group underwent RFVTR (n = 22)...
March 2000: Otolaryngology—Head and Neck Surgery
J J Smitka
Families have become "health care systems" by providing physical, emotional and social home care for their loved ones dependent on technology. Examples of home technology equipment include renal dialysis, mechanical ventilation for sleep apnea, electronic apnea monitoring for premature infants, intravenous infusions of antibiotics, hyperalimentation, or narcotics and spinal infusions for pain relief. There is much more to the 24 hours of family involvement than the actual bedside physical care. For example, some of the activities a family would need to do for a patient with an intravenous infusion of antibiotics is: go grocery shopping, setup the infusion, cleanse the infusion site, walk the dog, prepare meals, order supplies, clean the house, and check equipment for expiration dates...
April 1998: Kansas Nurse
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