Can assessment for obstructive sleep apnea help predict postadenotonsillectomy respiratory complications?

Anesthesiology. 2002 Feb;96(2):313-22. doi: 10.1097/00000542-200202000-00015.


Background: The aim of this study was to determine the frequency and type of respiratory complications after adenotonsillectomy in children. A second aim was to assess the ability of preoperative sleep studies to identify children at risk for respiratory complications.

Methods: Children referred for sleep studies between 1992 and 1998, who underwent adenotonsillectomy within 6 months of the preoperative study, were reviewed. The study focused on two variables: the obstructive apnea and hypopnea index and the oxygen saturation nadir. Medical charts were reviewed for postoperative respiratory complications.

Results: Three hundred forty-nine children were referred for sleep studies, and 163 met the inclusion criteria. Thirty-four children (21%) had postoperative respiratory complications requiring a medical intervention. Children experiencing respiratory complications were younger (aged < 2 yr; adjusted odds ratio, 4.3; 95% confidence interval, 1.7-11) and had an associated medical condition (odds ratio, 3; 95% confidence interval, 1.4-6.5). A preoperative obstructive apnea and hypopnea index of 5 or more events per hour increased the chance of postoperative respiratory complications (odds ratio, 7.2; 95% confidence interval, 2.7-19.3), as did a preoperative oxygen saturation nadir of 80% or less (odds ratio, 6.4; 95% confidence interval, 2.8-14.5). A preoperative oxygen saturation nadir of 80% or less had a likelihood ratio of 3.1, increasing the probability of postoperative respiratory complications from 20 to 50%.

Conclusions: The data suggest, but do not prove, that preoperative nocturnal oximetry could be a useful preoperative test to identify children who are at increased risk for postoperative respiratory complications.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoidectomy*
  • Child
  • Humans
  • Oxygen / blood
  • Polysomnography
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / epidemiology
  • Predictive Value of Tests
  • Respiratory Tract Diseases / diagnosis*
  • Respiratory Tract Diseases / epidemiology
  • Sleep Apnea, Obstructive / diagnosis*
  • Tonsillectomy*


  • Oxygen