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Postgraduate Education Corner: CONTEMPORARY REVIEWS IN SLEEP MEDICINE |

Perioperative Management of Obstructive Sleep Apnea

Adebola O. Adesanya, MD, FCCP; Won Lee, MD; Nancy B. Greilich, MD; Girish P. Joshi, MD
Author and Funding Information

From the Department of Anesthesiology (Drs Adesanya, Greilich and Joshi), Section of Perioperative Medicine (Dr Joshi), and the Department of Internal Medicine (Drs Adesanya and Lee), Pulmonary and Critical Care Medicine (Dr Lee), University of Texas Southwestern Medical Center, Dallas, TX.

Correspondence to: Adebola O. Adesanya, MD, FCCP, University of Texas Southwestern Medical Center, 5223 Harry Hines Blvd, Dallas, TX 75390-9069; e-mail: Adebola.Adesanya@UTSouthwestern.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(6):1489-1498. doi:10.1378/chest.10-1108
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Obstructive sleep apnea (OSA) is the most common breathing disorder, with a high prevalence in both the general and surgical populations. OSA is frequently undiagnosed, and the initial recognition often occurs during medical evaluation undertaken to prepare for surgery. Adverse respiratory and cardiovascular outcomes are associated with OSA in the perioperative period; therefore, it is imperative to identify and treat patients at high risk for the disease. In this review, we discuss the epidemiology of OSA in the surgical population and examine the available data on perioperative outcomes. We also review the identification of high-risk patients using clinical screening tools and suggest intraoperative and postoperative treatment regimens. Additionally, the role of continuous positive airway pressure in perioperative management of OSA and a brief discussion of ambulatory surgery in patients with OSA is provided. Finally, an algorithm to guide perioperative management is suggested.

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