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. 2016 Oct;23(2):103-110.
doi: 10.21454/rjaic.7518/232.pec.

The prevalence of perioperative complications in patients with and without obstructive sleep apnoea: a prospective cohort study

Tatiana Ambrosii  1 , Serghei Şandru  1 , Adrian Belîi  1
Affiliations

The prevalence of perioperative complications in patients with and without obstructive sleep apnoea: a prospective cohort study

Tatiana Ambrosii et al. Rom J Anaesth Intensive Care. 2016 Oct.

Abstract
in English, Romanian

Background and aims: Patients with obstructive sleep apnoea (OSA) have a high risk of postoperative complications. The purpose of the study was to record the spectrum and frequency of postoperative complications in patients with OSA versus (vs.) without OSA depending on the type of surgery and type of anaesthesia in a large cohort of patients.

Methods: We conducted a prospective, descriptive study (n = 400). Ethics Committee approval was obtained and written informed consent was signed. The Berlin screening questionnaire was used for OSA screening (77.2% - OSA [+]). Adverse events and complications were recorded postoperatively (AOS [+] vs. AOS [-]). Statistics: Chi square test.

Results: The highest rate of complications was found in patients who had underwent surgery in the abdominal cavity under general anaesthesia, AOS [+] vs. AOS [-]: cardiovascular [56.4%] vs. [7.5%], respiratory [17.6%] vs. [3.5%], stroke [0.7%] vs. [0.0% ], prolonged awakening from anaesthesia [2.5%] vs. [0.0%], postoperative fever [1.4%] vs. [0.3%], difficult orotracheal intubation [3.5%] vs. [0.3% ], unscheduled transfer to the intensive care unit [5.7%] vs. [0.0%].

Conclusions: OSA [+] patients who underwent abdominal surgery under general anaesthesia had a higher rate of complications compared to OSA [-] patients, and also compared to patients who had undergone peripheral limb surgery. Surgery on the musculoskeletal system is much better tolerated by patients with OSA, suffering a lower number and range of events and postoperative complications. Loco-regional anaesthesia should be considered a priority in patients with OSA.

Obiective: Pacienţii cu sindrom de apnee în somn de tip obstructiv (OSA) prezintă un risc crescut de complicaţii postoperatorii. Scopul acestui studiu a fost să înregistreze spectrul şi frecvenţa complicaţiilor postoperatorii la pacienţii cu OSA vs cei fără OSA în acord cu tipul de intervenţie chirurgicală şi de anestezie, într-o largă cohortă de pacienţi.

Metodă: Am derulat un studiu prospectiv şi descriptiv (n = 400). Au fost obţinute aprobarea Comitetului de Etică şi consimţământul scris, informat al pacienţilor. S-a utilizat chestionarul Berlin pentru depistarea OSA (77,2% – OSA [+]). Evenimentele adverse şi complicaţiile au fost înregistrate postoperator (OSA [+] vs OSA [−]). Pentru evaluarea statistică s-a utilizat testul Chi pătrat.

Rezultate: Rata maximă de complicaţii a fost înregistrată la pacienţii care au suferit intervenţii abdominale în anestezie generală, complicaţii OSA [+] vs OSA [−]: cardiovasculare [56,4%] vs [7,5%], respiratorii [17,6%] vs [3,5%], accidente vasculare cerebrale [0,7%] vs [0,0%], trezire întârziată din anestezie [2,5%] vs [0,0%], febră postoperatorie [1,4%] vs [0,3%], intubaţie orotraheală dificilă [3,5%] vs [0,3% ], internare neprogramată la terapie intensivă [5,7%] vs [0,0%].

Concluzii: Pacienţii cu OSA care au suferit intervenţii chirurgicale abdominale în anestezie generală au avut o rată mai crescută a complicaţiilor în comparaţie cu pacienţii OSA [−] şi cu pacienţii care au suferit intervenţii chirurgicale la nivelul membrelor. Chirurgia sistemului musculoscheletal este mult mai bine tolerată de către pacienţii cu OSA, aceştia înregistrând un număr mai redus de evenimente şi complicaţii postoperatorii. Datorită acestui fapt considerăm că anestezia loco-regională reprezintă o opţiune prioritară în cazul pacienţilor cu OSA.

Keywords: obstructive sleep apnoea; postoperative complications.

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Conflict of interest statement

Conflict of interest Nothing to declare

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