UYKU APNE SENDROMUNDA PREOPERATİF HAZIRLIK

Obstrüktif uyku apne sendromu olan hastalarda çeşitli nedenlerle intraoperatif ve postoperatifkomplikasyon riski artmaktadır. Perioperatif evrelerde sorun yaşanmaması icin operasyonöncesi tanı ve tedavilerinin sağlanarak optimum şartlarda operasyonun yapılması mortalite vemorbiditeyi azaltmak için gereklidir. Tam bir kardiyak ve pulmoner sistem muayenesi yapılarakhastanın optimal şartlarda ameliyata hazırlanması gerekmektedir. Bir diğer önemli risk faktörüise zor havayoludur. Preoperatif dönemde zor havayolu değerlendirilip gerekli önlemleralınmalıdır.

Preoperative Preparation In the Sleep Apnea Syndrome

In patients with obstructive sleep apnea syndrome, the risk of intraoperative and postoperative complications is increased for various reasons. In order to prevent problems in the perioperative stages, it is necessary to perform the operation in the optimum conditions by providing diagnosis and treatment before operation to decrease mortality and morbidity. A complete cardiac and pulmonary system examination should be performed and the patient should be prepared under optimal conditions. Another important risk factor is the difficult airway. In preoperative period difficult airway should be evaluated and necessary precautions should be taken.

PDF

___

1. Vasu TS, Grewal R, Doghramji K. Obstructive sleep apnea syndrome and perioperative complications: a systematic review of the literature. J Clin Sleep Med 2012; 8: 199-207.
2. Rosen CL. Obstructive sleep apnea syndrome (OSAS) in children: diagnostic challenges. Sleep 1996; 19: S274-S277.
3. Chung F,Memtsoudis GS, Ramachandran SK, et al. Society of Anesthesia and Sleep Medicine Guidelines on Preoperative Screening and Assessment of Adult Patients With Obstructive Sleep Apnea. Anesth Analg. 2016 Aug;123(2):452-73.
4. Peppard PE, Young T, Barnet JH, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013;177(9):1006–14.
5. Frey WC, Pilcher J. Obstructive sleep-related breathing disorders in patients evaluated for bariatric surgery. Obes Surg 2003;13(5):676–83.
6. Singh M, Liao P, Kobah S, et al. Proportion of surgical patients with undiagnosed obstructive sleep apnoea. Br J Anaesth 2013;110:629–36.
7. İtil O.Obstrüktif Uyku Apne Sendromunda Preoperatif Değerlendirme. Journal of Turkish Sleep Medicine 2015;3:47-52.
8. Kaw R, Pasupuleti V, Walker E, et al. Postoperative complications in patients with obstructive sleep apnea. Chest 2012;141(2):436– 41.
9. Hai F, Porhomayon J, Vermont L, et al. Postoperative complications in patients with obstructive sleep apnea: a meta-analysis. J Clin Anesth 2014;26(8):591–600.
10. Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108:812–821.
11. Ramachandran SK, Kheterpal S, Consens F, et al. Derivation and validation of a simple perioperative sleep apnea prediction score. Anesth Analg. 2010;110:1007–1015.
12. Chung F, Yegneswaran B, Liao P, et al. Validation of the Berlin questionnaire and American Society of Anesthesiologists checklist as screening tools for obstructive sleep apnea in surgical patients. Anesthesiology. 2008;108:822–830.
13. Seet E, Chua M, Liaw CM. High STOP-Bang questionnaire scores predict intraoperative and early postoperative adverse events. Singapore Med J. 2015;56:212–216.
14. Kim GH, Lee JJ, Choi SJ, et al. Clinical predictors of apnoeahypopnoea during propofol sedation in patients undergoing spinal anaesthesia. Anaesthesia. 2012;67:755–759.
15. Lockhart EM, Willingham MD, Abdallah AB, et al. Obstructive sleep apnea screening and postoperative mortality in a large surgical cohort. Sleep Med. 2013;14:407–415.
16. Coté GA, Hovis CE, Hovis RM, et al. A screening instrument for sleep apnea predicts airway maneuvers in patients undergoing advanced endoscopic procedures. Clin Gastroenterol Hepatol. 2010;8:660–665.e1
17. Mehta PP, Kochhar G, Kalra S, et al. Can a validated sleep apnea scoring system predict cardiopulmonary events using propofol sedation for routine EGD or colonoscopy? A prospective cohort study. Gastrointest Endosc. 2014;79:436–444.
18. Chung F, Abdullah HR, Liao P. STOP-Bang questionnaire: a practical approach to screen for obstructive sleep apnea. Chest. 2016;149:631–638.
19. Chung F, Yang Y, Brown R, Liao P. Alternative scoring models of STOP-bang questionnaire improve specificity to detect undiagnosed obstructive sleep apnea. J Clin Sleep Med. 2014;10:951–958.
20. Gross JB, Bachenberg KL, Benumof JL, Caplan RA, Connis RT, Coté CJ, et al. Practice guidelines for the perioperative management of patients with obstructive sleep apnea: a report by the American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea. Anesthesiology 2006; 104: 1081-93; quiz 1117.
21. Loadsman JA, Hillman DR. Anaesthesia and sleep apnoea. Br J Anaesth 2001; 86: 254-266.
22. Seet E, Chung F. Management of sleep apnea in adults - functional algorithms for the perioperative period: Continuing Professional Development. Can J Anaesth 2010; 57: 849-864.
23. Abdelsattar ZM, Hendren S, Wong SL, Campbell DA Jr, Ramachandran SK. The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study. Sleep. 2015;38:1205–1210.
24. Rennotte MT, Baele P, Aubert G, Rodenstein DO. Nasal continuous positive airway pressure in the perioperative management of patients with obstructive sleep apnea submitted to surgery. Chest. 1995;107:367–374.
25. Nagappa M, Mokhlesi B, Wong J, Wong DT, Kaw R, Chung F. The effects of continuous positive airway pressure on postoperative outcomes in obstructive sleep apnea patients undergoing surgery: a systematic review and meta-analysis. Anesth Analg. 2015;120:1013–1023.
26. Mutter TC, Chateau D, Moffatt M, Ramsey C, Roos LL, Kryger M. A matched cohort study of postoperative outcomes in obstructive sleep apnea: could preoperative diagnosis and treatment prevent complications? Anesthesiology. 2014;121:707–718.
27. Oksenberg A, Arons E, Nassar K, et al. REM-related obstructive sleep apnea: the effect of body position. J Clin Sleep Med 2010;6:343-8.
28. Bali Ç,Akın Ş. Obstrüktif Uyku Apne Sendromu ve Anestezi. Abant Med J 2015;4(2):191-19.
29. Practice guidelines for management of difficult airway: An updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 118(2), 2013.
30. Hillman DR, Platt PR, Eastwood PR. The Upper Airway during anesthesia. British Journal of Anesthesia 2003;91:31-9.
31. Türk Anesteziyoloji ve Reanimasyon Derneği Anestezi Uygulama Kılavuzları. www.tard.org.tr/assets/kilavuz/4.pdf