Perioperative safety and complications in treatment of oral and maxillofacial surgery patients under general anesthesia with obstructive sleeping disorders

Abstract

Patients with sleeping disorders, such as obstructive sleep apnea, (OSA) have a higher risk for postoperative complications after maxillofacial surgery under general anesthesia. The aim of this study was to detect specific complications after oral and maxillofacial surgery. Sixty-nine cases of patients with middle or severe sleep apnea who underwent an operation under general anesthesia in the oral and maxillofacial region were retrospectively analyzed. This group was compared with an age and diagnosis matched group without sleep apnea receiving the same operative treatment. We found a significant difference between the two groups concerning body mass index, the ASA-Index, the Cormack-Mallampati Index, the number of pre-existing conditions, and home medication (p < 0.05). Concerning the length of stay, overrun of estimated mean length of stay, and number of surgical complications and hypertonic events, no difference could be detected. Almost 28% of the patients with OSA in our study suffered a substantial respiratory complication even under intensive care observation. The number of patients with oxygen desaturation was 9% in the control group, which differed significantly (p = 0.0093) from the number of such patients in the OSA group. In this study, we have shown that the presence of OSA in patients undergoing elective maxillofacial surgery is associated with a considerable number of comorbidities in the postoperative period. Through preoperative OSA screening and OSA evaluation, an improvement in management of surveillance resources could be achieved and the OSA-specific risk could be assessed more precisely and also reduced.

Keywords: Complications; Maxillofacial surgery; OSA; Obstructive sleep apnea; Perioperative management.