Post-Sleep Apnea Surgery Complications Examined

Review finds that routine admission to the intensive care unit for all patients is unnecessary

THURSDAY, March 22 (HealthDay News) -- The overall complication rate of multilevel surgery for obstructive sleep apnea (OSA) is 7.1 percent, according to research published online March 19 in the Archives of Otolaryngology -- Head & Neck Surgery.

To investigate the safety of multilevel surgery for patients with OSA, Kenny P. Pang, M.D., of the Pacific Sleep Centre in Singapore, and colleagues analyzed data from 487 consecutive patients with OSA and 1,698 multilevel surgical procedures, including nasal surgery, palate surgery, and tongue surgery. Severe OSA was defined as an apnea-hypopnea index >60 and the lowest oxygen saturation level <80 percent.

The researchers found that the overall complication rate was 7.1 percent. One patient had an upper airway obstruction; other complications included six patients with postoperative oxygen desaturation within three hours following extubation (all had severe OSA); 15 patients with persistent hypertension (all had a history of hypertension); 15 patients with secondary hemorrhage seven to 12 days after surgery; two cases of negative pressure pulmonary edema; nine patients with tongue edema after tongue surgery; and one patient with upper airway obstruction, which necessitated reintubation. Patients who underwent tongue surgery were routinely admitted to the high-dependency unit.

"Routine postoperative admission to the intensive care unit for all patients with OSA is unnecessary," the authors write. "These patients should be closely monitored in the post-anesthesia care unit area after surgery, and based on the outcome of this period, they can be observed overnight in either the high-dependency unit or the general ward."

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