Postoperative treatment of the patient with obstructive sleep apnea

OBJECTIVE: The postoperative management of patients with obstructive sleep apnea syndrome (OSAS) has been based primarily on the potential loss of the airway, Our hypothesis is that not all patients with OSAS require placement in the intensive care unit after surgery. METHODS: We undertook a prospective, nonrandomized study (N = 38). Data included demographics, polysomnograms, body mass index (BMI), and postoperative course, including any complications within 72 hours. RESULTS: The average respiratory disturbance index was 66, and the average BMI was 29, The average preoperative and postoperative maximal arterial oxygen desaturation values were 82% and 94%, respectively, Patients with BMIs less than 35 did not have desaturation values below 90%. No complications occurred, DISCUSSION: Within the first 72 hours after surgery, no complications were observed in our study groups. Patients with BMIs greater than 35 were at increased risk for postoperative desaturations. The uncomplicated OSAS patient, one without significant comorbid factors, can be treated in a safe and prudent fashion outside of an intensive care unit.