J U LY 2 0 1 5 O U T P A T I E N TS U R G E R Y. N E T 5 3
serious condition — you want to leave
time to discuss it with your team.
Assessing a patient's OSA status several
days in advance of surgery lets you
assess if he's a candidate for outpatient
surgery and plan appropriately.
According to practice guidelines
issued in February 2014 by the
American Society of Anesthesiologists,
you should weigh several factors when
determining if patients are suitable for
the ambulatory setting. What is their
sleep apnea status? How old are they?
Do they have anatomical and physio-
logical abnormalities? What about
coexisting diseases? What procedures
are they scheduled to undergo and
what type of anesthesia is required?
Will opioids be needed to control their
pain? Is there a caregiver at home who
can monitor their recovery? An honest
assessment of all these factors and the
capabilities of your care team will help
guide your decision.
2. Teamwork and communication are crucial. The anes-
thesiologist who suspects sleep apnea needs to tell the surgeon, I'm unable to
ascertain the severity, but you should be aware. He also knows how adept the
operative team is in emergency airway interventions. That should be part of the
PATIENT SCREENING
The STOPBANG Obstructive
Sleep Apnea Questionnaire
• Do you SNORE loudly?
• Do you often feel TIRED during the day?
• Has anyone OBSERVED you stopping breath-
ing while you sleep?
• Do you have high blood PRESSURE?
• Is your BMI more than 35?
• Is you AGE over 50?
• Is your NECK circumference greater
than 16 inches?
• Is your GENDER Male?
5 to 8 yes answers: High risk
3 or 4: Intermediate risk
0 to 2: Low risk
