Perioperative Management of Obstructive Sleep Apnea

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 CHEST 2010, 138(6) 1489-1498