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Wake Up to the Dangers of Sleep Apnea - October 2018 - Subscribe to Outpatient Surgery Magazine

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treat the patient with a reversal agent — typically either sugammadex or neostigmine — at the end of the procedure to reverse its effects. Though the guideline doesn't recommend using one reversal agent over another, Mr. Schmidt prefers using sugammadex because evi- dence suggests it can reverse the effects of the NMBA faster and cause fewer adverse events than neostigmine. 3. Find a better analgesic. Because opioids are known to have respiratory depressant effects, the guideline suggests that facilities should carefully consider their role in treating sleep apnea patients. "Although potent analgesics, opioids depress breathing in all patients — and may do so more in sleep apnea patients," says Dr. Memtsoudis. "It's probably good to reduce the reliance on opioids in all patients when possible because of their known side effects." Instead, consider other non-opioid analgesics known to treat pain without any respiratory depression, like IV NSAIDs acetaminophen or ketorolac, says Mr. Schmidt. He notes that pre-operative gabapentin, O C T O B E R 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 3 9

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