Clinical predictors of apnoea-hypopnoea during propofol sedation in patients undergoing spinal anaesthesia

Abstract

This study assessed the relationship between the occurrence of apnoea-hypopnoea during propofol sedation for spinal anaesthesia and two different predictive tests of sleep apnoea: the STOP-Bang score (snoring while sleeping, daytime tiredness, observed breathing stoppages, high blood pressure-body mass index, age, neck circumference, gender); and the obstructive sleep apnoea (OSA) score. Thirty-four middle-aged men not diagnosed with obstructive sleep apnoea received propofol infusions adjusted to produce a bispectral index of 70-75. ApnoeaLink(TM) was used to estimate the incidence of apnoea-hypopnoea. The median (IQR [range]) apnoea-hypopnoea index was 17 (8-24 [0-70]) events.h(-1) and correlated weakly with the STOP-Bang score (p = 0.022, r = 0.423) and moderately with the OSA score (p < 0.001, r = 0.693). Severe apnoea-hypopnoea developed more frequently in patients with a higher OSA score (34.5% vs 0%) or higher STOP-Bang score (27.6% vs 6.9%). Both assessment tools have some predictive value for the occurrence of apnoea-hypopnoea during propofol sedation in patients undergoing spinal anaesthesia.