Monday, April 4, 2011

OSA and Perioperative Complications in Bariatric Patients

Article in the British Journal of Anaesthesia about OSA and complications around the time of surgery in obese patients. Obese patients, with and without OSA, are at higher surgical risk. It's assumed that OSA is an independent risk factor for perioperative complications, but the article says there is not much objective data to support that.

Currently, bariatric surgeons typically have their patients have a sleep study prior to weight loss surgery. If there is significant OSA, than the patient is treated for several weeks to months with CPAP prior and upto the weight loss surgery.

The authors of this study studied patients that had a pre-op sleep study. Ninety-three percent of the patients with OSA received perioperative positive airway pressure therapy. All patients were closely monitored after operation. The overall complication rate was increased with open procedures compared with laparoscopic. In addition, increased BMI and age were associated with increased likelihood of pulmonary and other complications. Complication rates were not associated with OSA severity.

The authors concluded that in obese patients evaluated by sleep study before bariatric surgery and managed accordingly, the severity of OSA (the AHI), was not associated with the rate of perioperative complications. Thus, either OSA is not an independent risk factor for complications or the recognition and management of OSA in the perioperative period mitigates this risk. These results cannot determine whether unrecognized and untreated OSA increases risk.

No comments:

Post a Comment