Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome

Braz J Anesthesiol. Sep-Oct 2015;65(5):359-66. doi: 10.1016/j.bjane.2014.02.008. Epub 2014 Mar 12.

Abstract

Introduction: Patients with STOP-BANG score >3 have a high risk of Obstructive sleep apnea. The aim of this study was to evaluate early postoperative respiratory complications in adults with STOP-BANG score >3 after general anesthesia.

Methods: This is a prospective double cohort study matching 59 pairs of adult patients with STOP-BANG score >3 (high risk of obstructive sleep apnea) and patients with STOP-BANG score <3 (low risk of obstructive sleep apnea), similar with respect to gender, age and type of surgery, admitted after elective surgery in the Post-Anaesthesia Care Unit in May 2011. Primary outcome was the development of adverse respiratory events. Demographics data, perioperative variables, and postoperative length of stay in the Post-Anesthesia Care Unit and in hospital were recorded. The Mann-Whitney test, the chi-square test and the Fisher exact test were used for comparisons.

Results: Subjects in both pairs of study subjects had a median age of 56 years, including 25% males, and 59% were submitted to intra-abdominal surgery. High risk of obstructive sleep apnea patients had a higher median body mass index (31 versus 24kg/m(2), p<0.001) and had more frequently co-morbidities, including hypertension (58% versus 24%, p<0.001), dyslipidemia (46% versus 17%, p<0.001) and insulin-treated diabetes mellitus (17% versus 2%, p=0.004). These patients were submitted more frequently to bariatric surgery (20% versus 2%, p=0.002). Patients with high risk of obstructive sleep apnea had more frequently adverse respiratory events (39% versus 10%, p<0.001), mild to moderate desaturation (15% versus 0%, p=0.001) and inability to breathe deeply (34% versus 9%, p=0.001).

Conclusion: After general anesthesia high risk of obstructive sleep apnea patients had an increased incidence of postoperative respiratory complications.

Keywords: Apneia obstrutiva do sono; Desfecho no pós-operatório; Eventos respiratórios; Obstructive sleep apnea; Postoperative outcome; Respiratory events.

MeSH terms

  • Adult
  • Aged
  • Anesthesia, General / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Prospective Studies
  • Respiratory Tract Diseases / etiology*
  • Risk
  • Sleep Apnea, Obstructive / complications*