Perioperative Problems In Sleep Apnea Patients
Sleep apnea is a serious medical condition, yet the majority of cases haven't even been diagnosed. It's this fact that gives anesthesiologists concern. If a person needs surgery, and also suffers from sleep apnea, serious perioperative problems may result. It is vital that a doctor correctly screens each patient before surgery, asking specific questions that can identify sleep apnea, which decreases perioperative difficulties.
Types of Problems
Sleep apnea is a condition whereby a person stops breathing for a minimum of ten seconds, but this time could be longer. An obstructive factor or a miscommunication between the brain and the respiratory system can cause this problem. However, perioperative problems and sleep apnea go together. Administering anesthesia has a possibility of worsening sleep apnea symptoms, by relaxing the important airway muscles to a further degree.
There is a greater chance of breathing distress both during and after surgery. This would decrease the necessary oxygen flow to the brain and may pose a significant threat to the patient. Besides anesthesia, certain analgesics also have this effect on the throat muscles and should be used with caution in a patient who has sleep apnea.
Minimizing Surgical Complications
Perioperative problems in sleep apnea patients can be minimized in several ways. The first step is accurately determining if the patient has this disorder. Being prepared for this condition will give the anesthesiologist time to have a plan of action ready. Since certain sedatives may contribute to episodes of sleep apnea, a careful selection of medications should be decided upon before the surgical procedure. During surgery, the focus of the anesthesiologist will be on keeping the airways open to allow free breathing.
After surgery, special care needs to be given to sleep apnea patients, checking to see if there is any swelling of the throat muscles as a result of intubation, which is placing a tube in the air passage to provide breathing support during surgery. This tube may stay in place until the patient is fully awake and breathing without difficulty. A Continuous Positive Airway Pressure (CPAP) machine should be used to aid the patient after surgery.
Perioperative problems in sleep apnea patients can be greatly diminished or even eliminated by a thorough evaluation. Recognizing that a patient has sleep apnea, even if this condition had never been formally diagnosed, is a crucial step before any surgical procedure. With that knowledge in hand, the anesthesiologist can aggressively monitor the patient, with attention given to any breathing complications. Because surgery, with its use of anesthesia and other sedative drugs, can seriously affect a sleep apnea patient's breathing, out-patient or same-day surgery is not recommended because of possible complications that may arise at home and away from the careful monitoring provided in a hospital.
