"This population is at high risk of complications from surgery," says
Stavros G. Memtsoudis, MD, PhD, anesthesiologist at the Hospital for
Special Surgery in New York City and one of the co-authors of the
new intraoperative OSA guideline by the Society of Anesthesia and
Sleep Medicine (SASM). "This is a very common condition. We think
amongst orthopedic patients that anywhere between 1 in 4 or 1 in 5
patients have OSA. That makes it potentially more common than
many commonly known diseases in surgical patients."
Below, anesthesia experts share 5 of the highlights of the new SASM
Guideline on Intraoperative Management of Adult Patients With
Obstructive Sleep Apnea (osmag.net/4QqFMy) and how to best
implement the recommendations at your facility.
1. Know the risks of OSA in surgical patients.
The guideline starts off with the strong recommendation that
"patients with OSA should be considered at increased risk for difficult
airway challenges compared with patients without OSA." But do your
staff members know how much of a risk having a patient with undiag-
nosed OSA really is?
"In the context of surgery where we give patients medications that
affect breathing patterns, and fluids which can increase edema and
fluid in the airways, symptoms of sleep apnea may become worse,"
says Dr. Memtsoudis. "Those having OSA and who are not treated are
at risk of cardiovascular and respiratory complications after surgery."
While the latest guideline covers intraoperative practices, SASM
released pre-operative guidelines back in 2016
(osmag.net/YhWW2o). In those, it was highly recommended that
facilities implement a screening process to identify OSA patients
before they step foot in the OR. These guidelines note that the gold
standard for diagnosis of OSA is polysomnography, but due to its
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