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OSA AND ANESTHESIA

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https://www.readbyqxmd.com/read/30371885/displacement-of-the-hyoid-bone-by-muscle-paralysis-and-lung-volume-increase-effects-of-obesity-and-obstructive-sleep-apnea
#1
Akane Kohno, Yuji Kitamura, Shinichiro Kato, Hirohisa Imai, Yoshitada Masuda, Yasunori Sato, Shiroh Isono
Study Objectives: Animal studies suggest a pivotal role of the hyoid bone in obstructive sleep apnea (OSA). We aimed to explore the role of the hyoid bone in humans by testing the hypotheses that muscle paralysis and lung volume (LV) changes displace the hyoid bone position particularly in patients with obesity and/or OSA. Methods: Fifty patients undergoing general anesthesia participated in this study (20 non-obese, non-OSA subjects; 8 non-obese patients with OSA; 22 obese OSA patients)...
October 29, 2018: Sleep
https://www.readbyqxmd.com/read/30285632/a-high-risk-of-sleep-apnea-is-associated-with-less-postoperative-cognitive-dysfunction-after-intravenous-anesthesia-results-of-an-observational-pilot-study
#2
Soeren Wagner, Joerg Quente, Sven Staedtler, Katharina Koch, Tanja Richter-Schmidinger, Johannes Kornhuber, Harald Ihmsen, Juergen Schuettler
BACKGROUND: The obstructive sleep apnea syndrome (OSAS) is characterized by temporary cerebral hypoxia which can cause cognitive dysfunction. On the other hand, hypoxia induced neurocognitive deficits are detectable after general anesthesia. The objective of this study was to evaluate the impact of a high risk of OSAS on the postoperative cognitive dysfunction after intravenous anesthesia. METHODS: In this single center trial between June 2012 and June 2013 43 patients aged 55 to 80 years with an estimated hospital stay of at least 3 days undergoing surgery were enrolled...
October 2, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/30278569/a-double-blind-randomized-placebo-controlled-pilot-study-of-single-dose-preoperative-modafinil-for-functional-recovery-after-general-anesthesia-in-patients-with-obstructive-sleep-apnea
#3
RANDOMIZED CONTROLLED TRIAL
Zyad J Carr, Brian Vells, Brendan R Wood, Joshua D Lowery, Ann M Rogers, Allen A Kunselman, Kunal Karamchandani, Sonia J Vaida
BACKGROUND: We theorized that modafinil, an atypical psychomotor stimulant, utilized to improve daytime somnolence in patients with obstructive sleep apnea, would improve functional recovery after general anesthesia by improving time to extubation, post-anesthesia care unit (PACU) length of stay and subjective recovery after general anesthesia. METHODS: A double blind, randomized, placebo-controlled pilot study was performed. 102 patients with the diagnosis of obstructive sleep apnea (OSA) were randomized to receive either 200 mg of modafinil or placebo before general anesthesia...
September 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30199402/best-perioperative-practice-in-management-of-ambulatory-patients-with-obstructive-sleep-apnea
#4
Mahesh Nagappa, Yamini Subramani, Frances Chung
PURPOSE OF REVIEW: The perioperative outcome in obstructive sleep apnea (OSA) patients undergoing ambulatory surgery can be potentially impacted by the type of anesthetic technique, fluid management and choice of anesthetic agents. This review highlights the best perioperative practices in the management of OSA patients undergoing ambulatory surgical procedures. RECENT FINDINGS: A recent meta-analysis found that STOP-Bang might be used as a perioperative risk stratification tool...
December 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/30104879/assessment-of-the-berlin-questionnaire-for-evaluation-of-hypoxemia-risk-in-subjects-undergoing-deep-sedation-for-screening-gastrointestinal-endoscopy
#5
Shiue-Chin Liou, Chen-Ming Hsu, Chit Chen, Ming-Yao Su, Cheng-Tang Chiu
Background: Subjects with obstructive sleep apnea (OSA) are vulnerable to sedation-related complications during endoscopic procedures. A significant portion of subjects undergoing routine endoscopy is at high risk of OSA, but most are undiagnosed. The purpose of this study was to estimate the prevalence of high risk for OSA among Chinese subjects undergoing deep sedation for screening gastrointestinal endoscopy and to evaluate the hypoxemia risk of these examinees stratified by Berlin Questionnaire (BQ)...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/30026927/obstructive-sleep-apnea-as-an-independent-predictor-of-postoperative-delirium-and-pain-protocol-for-an-observational-study-of-a-surgical-cohort
#6
Patricia Strutz, William Tzeng, Brianna Arrington, Vanessa Kronzer, Sherry McKinnon, Arbi Ben Abdallah, Simon Haroutounian, Michael S Avidan
Introduction : Postoperative delirium and pain are common complications in adults, and are difficult both to prevent and treat. Obstructive sleep apnea (OSA) is prevalent in surgical patients, and has been suggested to be a risk factor for postoperative delirium and pain. OSA also might impact pain perception, and alter pain medication requirements. This protocol describes an observational study, with the primary aim of testing whether OSA is an independent predictor of postoperative complications, focusing on (i) postoperative incident delirium and (ii) acute postoperative pain severity...
2018: F1000Research
https://www.readbyqxmd.com/read/30017712/perioperative-safety-and-complications-in-treatment-of-oral-and-maxillofacial-surgery-patients-under-general-anesthesia-with-obstructive-sleeping-disorders
#7
Evgeny Goloborodko, Ann Christina Foldenauer, Nassim Ayoub, Matthias Knobe, Stephan Christian Möhlhenrich, Kristian Kniha, Frank Hölzle, Ali Modabber
Patients with sleeping disorders, such as obstructive sleep apnea, (OSA) have a higher risk for postoperative complications after maxillofacial surgery under general anesthesia. The aim of this study was to detect specific complications after oral and maxillofacial surgery. Sixty-nine cases of patients with middle or severe sleep apnea who underwent an operation under general anesthesia in the oral and maxillofacial region were retrospectively analyzed. This group was compared with an age and diagnosis matched group without sleep apnea receiving the same operative treatment...
September 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29944522/society-of-anesthesia-and-sleep-medicine-guideline-on-intraoperative-management-of-adult-patients-with-obstructive-sleep-apnea
#8
Stavros G Memtsoudis, Crispiana Cozowicz, Mahesh Nagappa, Jean Wong, Girish P Joshi, David T Wong, Anthony G Doufas, Meltem Yilmaz, Mark H Stein, Megan L Krajewski, Mandeep Singh, Lukas Pichler, Satya Krishna Ramachandran, Frances Chung
The purpose of the Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea (OSA) is to present recommendations based on current scientific evidence. This guideline seeks to address questions regarding the intraoperative care of patients with OSA, including airway management, anesthetic drug and agent effects, and choice of anesthesia type. Given the paucity of high-quality studies with regard to study design and execution in this perioperative field, recommendations were to a large part developed by subject-matter experts through consensus processes, taking into account the current scientific knowledge base and quality of evidence...
October 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29868460/anesthesia-preoperative-clinic-evaluation-of-obstructive-sleep-apnea-using-nasal-fiberoptic-videoendoscopy-a-pilot-study-comparison-with-polysomnography
#9
Sandeep Jain, Peter J Kallio, Kenneth Less, Jutta Novalija, Paul S Pagel, Thomas J Ebert
Background: Nasal fiberoptic videoendoscopy is an established technique to assess upper airway pathology in conscious and sedated patients. Objectives: The authors conducted a prospective proof-of-concept pilot study to evaluate whether airway narrowing detected using nasal fiberoptic videoendoscopy in the anesthesia preoperative clinic was capable of defining the severity of obstructive sleep apnea (OSA) in patients scheduled for elective surgery. Methods: After application of topical local anesthesia (4% lidocaine with phenylephrine), sixteen patients (ASA physical status 2 or 3) underwent nasal fiberoptic videoendoscopy in sitting position...
February 2018: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29851818/difficulty-in-tracheal-extubation-followed-by-tracheal-collapse-after-balloon-dilatation-for-tracheal-stenosis-therapy-a-case-report
#10
Nana Li, Linjia Zhu, Jie Sun, Yinbing Pan, Mei Gao
RATIONALE: Tracheobronchomalacia (TBM) refers to the weakening trachea or the trachea loss of structural integrity of airway cartilaginous structures. It causes tracheal stenosis, resulting in significantly high rates of mortality. Bronchoplasty by high-pressure balloon dilation under general anesthesia is a simple but effective and safe method to treat tracheobronchial stenosis. However, recurrent postoperative dyspnea after extubation due to tracheal collapse is still a challenge for anesthetists...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29756745/controversies-in-office-based-anesthesia-obstructive-sleep-apnea-considerations
#11
Ruchir Gupta, Srinivas Pyati
As the number of procedures being performed in the office-based anesthesia (OBA) setting are increasing, so are the number of patients presenting for surgery with obstructive sleep apnea (OSA). There continues to be controversy regarding whether these patients can be safely cared for in the OBA setting. To date, no national guideline has clearly addressed this issue and while some have extrapolated lessons from what has been published for OSA in the ambulatory surgery center (ASC) setting, some argue that there is a significant difference in the availability of resources in the ASC versus the OBA setting...
September 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29755518/double-barrel-nasal-trumpets-to-prevent-upper-airway-obstruction-after-nasal-and-non-nasal-surgery
#12
Macario Camacho, Justin M Wei, Lauren K Reckley, Sungjin A Song
Objectives: During anesthesia emergence, patients are extubated and the upper airway can become vulnerable to obstruction. Nasal trumpets can help prevent obstruction. However, we have found no manuscript describing how to place nasal trumpets after nasal surgery (septoplasties or septorhinoplasties), likely because (1) the lack of space with nasal splints in place and (2) surgeons may fear that removing the trumpets could displace the splints. The objective of this manuscript is to describe how to place nasal trumpets even with nasal splints in place...
2018: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/29754874/preoperative-screening-for-obstructive-sleep-apnea-and-outcomes-in-pacu
#13
Jill Setaro, Ruth Reinsel, Dana Brun
PURPOSE: Practice guidelines from the perianesthesia community suggest that preoperative identification of patients with obstructive sleep apnea (OSA) and standardized longer observation in postanesthesia care unit (PACU) promotes safety after general anesthesia. The purpose of this study was to determine if longer monitoring of patients with OSA in the PACU improves patient outcomes after general anesthesia. DESIGN: Evidence-based best practices literature review...
May 10, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29680176/perianesthesia-nurses-survey-of-their-knowledge-and-practice-with-obstructive-sleep-apnea
#14
Andrea M Erwin, Kim A Noble, June Marshall, Susan Cooper
PURPOSE: Anesthesia, sedation, and analgesia can negatively impact adult patients with obstructive sleep apnea (OSA). Despite known risks, current evidence, and practice guidelines, insufficient evidence exists that standardization and clinical application of OSA screening tools, problem identification, and perioperative nursing intervention and management strategies are consistently implemented for OSA patients across perianesthesia settings. The purpose of this study was to conduct a knowledge and practice assessment of perianesthesia nurses who care for adult patients with diagnosed or undiagnosed OSA...
April 18, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29623221/efficacy-of-dexmedetomidine-versus-ketofol-for-sedation-of-postoperative-mechanically-ventilated-patients-with-obstructive-sleep-apnea
#15
Hatem Elmoutaz Mahmoud, Doaa Abou Elkassim Rashwan
Patients with sleep apnea are prone to postoperative respiratory complications, requiring restriction of sedatives during perioperative care. We performed a prospective randomized study on 24 patients with obstructive sleep apnea (OSA) who underwent elective surgery under general anesthesia. The patients were equally divided into two groups: Group Dex : received dexmedetomidine loading dose 1 mcg/kg IV over 10 min followed by infusion of 0.2-0.7 mcg/kg/hr; Group KFL : received ketofol as an initial bolus dose 500 mcg/kg IV (ketamine/propofol 1 : 1) and maintenance dose of 5-10 mcg/kg/min...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29609705/ambulatory-surgery-has-minimal-impact-on-sleep-parameters-a-prospective-observational-trial
#16
Arlene J Hudson, Robert J Walter, John Flynn, Dale F Szpisjak, Cara Olsen, Matthew Rodgers, Vincent F Capaldi, Brent McDuffie, Christopher J Lettieri
STUDY OBJECTIVES: The presence of obstructive sleep apnea (OSA) in ambulatory surgical patients causes significant perioperative concern; however, few data exist to guide clinicians' management decisions. The objective of this study was to measure changes in perioperative sleep parameters among an ambulatory surgery population. METHODS: This study is a prospective, observational study of ambulatory patients undergoing orthopedic surgery on an extremity. Study subjects completed three unattended home sleep apnea tests: baseline before surgery, the first night after surgery (N1), and third night after surgery (N3)...
April 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29501307/respiratory-events-after-adenotonsillectomy-requiring-escalated-admission-status-in-children-with-obstructive-sleep-apnea
#17
Alexandra M Arambula, Deborah X Xie, Amy S Whigham
OBJECTIVES: To characterize postoperative respiratory complications following adenotonsillectomy (AT) in children with obstructive sleep apnea (OSA) and to identify variables associated with pediatric intensive care unit (PICU) admission. METHODS: Retrospective analysis of 133 pediatric OSA patients with prior AT. Assessment of the postoperative hospital course informed patient stratification based on respiratory event severity, PICU admission status, and unscheduled escalation of care...
April 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29492464/a-retrospective-analysis-on-patients-at-high-risk-for-obstructive-sleep-apnea-undergoing-ear-nose-and-throat-surgeries
#18
Karina Woodling, Juan Fiorda-Diaz, Bradley A Otto, Christie A Barnes, Alberto A Uribe, Sergio D Bergese, Vedat Yildiz, Nicoleta Stoicea, Michael G Guertin
Background: Obstructive sleep apnea (OSA) may be related to episodes of oxygen de-saturation, hypercapnia, cardiovascular dysfunction, cor-pulmonale, and pulmonary hypertension. STOP-BANG is an acronym for eight specific questions used to assess the likelihood of OSA. If the individual exhibits three or more of these indicators, he/she should be considered to be at high risk for OSA complications. Therefore, the decision of proceeding with inpatient versus outpatient ENT surgery still remains controversial...
February 2018: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29481438/research-needs-assessment-for-children-with-obstructive-sleep-apnea-undergoing-diagnostic-or-surgical-procedures
#19
Kimmo T Murto, Wesley Chen, Sherri L Katz, Deborah A Schwengel, Lisa M Elden, Kumar G Belani, David Gozal
Recent concerns have been raised about the quality and safety of adenotonsillectomy, a common surgery performed to treat obstructive sleep apnea (OSA) in children. OSA is a risk factor for opioid-related perioperative respiratory complications including those associated with anoxic brain injury or death. Our objective was to identify controversial issues related to the care of children with OSA. A standardized Delphi consensus technique involving an interdisciplinary group of 24 pediatric OSA experts identified 3 key issues: "postoperative disposition, preoperative screening, and pain management...
July 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29458333/pre-anesthetic-assessment-with-three-core-questions-for-the-detection-of-obstructive-sleep-apnea-in-childhood-an-observational-study
#20
Joerg Schnoor, Thilo Busch, Nazar Turemuratov, Andreas Merkenschlager
BACKGROUND: Children with obstructive sleep apnea are at high risk for perioperative airway obstruction. Many "at risk" children may remain unrecognized. The aim of this study is to find a clinically practicable test to identify obstructive sleep apnea in childhood. METHODS: In this pilot study, we prospectively compared four parental questionnaires with the respective findings of subsequent sleep laboratory testing in children. Right before sleep laboratory testing, children's parents answered both the Pediatric Sleep Questionnaire, a subscale of the Sleep Related Breathing Disorder questionnaire (PSQ-SRBD-Subscale), and an eight-item questionnaire derived from it...
February 20, 2018: BMC Anesthesiology
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