March 20, 2012

Sleep Apnea Surgery Safe

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Chris Galloway, M.D. By:

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Surgery for sleep apnea does not require ICU afterward but does need close observation

(dailyRx News) Patients getting surgery for obstructive sleep apnea have less to fear. Complication rates from the surgery are low enough that time in the ICU appears unwarranted.

Although surgery for sleep apnea has previously been regarded as very risky, a recent review of cases revealed that patients undergoing the procedure experienced a low enough rate of complications that close monitoring in the recovery room or a similar area, rather than in the ICU, is the best after the surgery.

"Surgery for sleep apnea has very low complication rate."

Surgeon Kenny Pang, of the Pacific Sleep Centre in Singapore, led the study looking retrospectively at 487 patents who had multilevel surgery on the nose, palate and/or tongue for obstructive sleep apnea between January 2007 and May 2010.

The overall complication rate was 7.1 percent, they found. Among the challenges to sleep apnea surgery are the small lower jaws and restricted airways of most people who have it, which makes it difficult for anesthesiologists to administer tubes with anesthesia effectively and safely.

Another challenge is that muscle relaxants or pain-relieving narcotics have been shown in sleep apnea patients to slow a person's breathing to the point that they are unable to get adequate oxygen while breathing, leading to a build-up of carbon dioxide.

Yet the low rates of these complications mean that routinely transferring patients after the operation to the ICU may not be necessary. Instead, the authors recommend that the patients be closely monitored for at least three hours after the surgery either in the recovery room or in another area with a high level of attentiveness from nurses.

"In conclusion, we strongly recommended that the clinician manage the patient with OSA with caution and prudence, with the understanding that these patients have a higher risk of airway compromise and respiratory depression intraoperatively and postoperatively," the authors write.

The research appeared online March 19 in the JAMA journal Archives of Otolaryngology – Head & Neck Surgery. The authors reported no financial conflicts of interest.
 

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Reviewed by: 
Chris Galloway, M.D.
Review Date: 
March 18, 2012

Last Updated:
March 20, 2012