Immediate complications related to anesthesia in patients undergoing uvulopalatopharyngoplasty for obstructive sleep apnea

Authors

  • Benjamin Talei MD,

    Corresponding author
    1. Departments of Otolaryngology/Head & Neck Surgery, Cornell University Medical College, New York Presbyterian Hospital, New York, New York, U.S.A
    • Send correspondence to Ben Talei, 1320 York Ave 22J, New York, NY 10021. E-mail: MuyBenno@gmail.com

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  • Anne L. Cossu MD,

    1. Departments of Anesthesia, Cornell University Medical College, New York Presbyterian Hospital, New York, New York, U.S.A
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  • Ralph Slepian MD,

    1. Departments of Anesthesia, Cornell University Medical College, New York Presbyterian Hospital, New York, New York, U.S.A
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  • Ashutosh Kacker MD

    1. Departments of Otolaryngology/Head & Neck Surgery, Cornell University Medical College, New York Presbyterian Hospital, New York, New York, U.S.A
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  • Presented at the Triological Society Combined Sections Meeting, Miami, Florida, U.S.A., January 26–28, 2012.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

To analyze and assess the perioperative risks and complications in patients receiving general anesthesia undergoing surgery for obstructive sleep apnea (OSA).

Study Design

Retrospective chart review of patients with documented OSA who underwent uvulopalatopharyngoplasty (UPPP) with or without septoplasty for OSA between January 2009 and January 2010 at a specific institution. Anesthesia, operative, clinical, and postoperative/recovery nursing records were collected and reviewed for predetermined complications and risk factors.

Methods

Chart review was performed via electronic medical records, reviewing the perioperative course of 32 patients undergoing UPPP as identified by Current Procedural Terminology coding. Perioperative, clinical, and anesthetic records were reviewed for any complications and risks, defined as any adverse event delaying surgical progress or recovery along with any additional risk to patient safety. Criteria included interventions beyond those involved in undergoing routine general anesthesia. This included difficult intubation, reintubation, postoperative pulmonary edema, postoperative desaturations, and/or need for continuous positive airway pressure. The data obtained were stratified into results for intubation and special equipment needed along with airway visibility and intubation technique, reintubation, induction and supplemental drugs, neuromuscular blockade, neuromuscular blockade reversal, pain medications, body mass index, and overall anesthesia risk.

Results

Thirty-two patients were reviewed with no severe adverse events such as reintubation, prolonged intubation, or postoperative pulmonary edema. Patients who were difficult to intubate or required nasal/oral airways failed to show any adverse outcomes.

Conclusions

Patients undergoing surgery for OSA are considered to be at increased risk of complications. Review of 32 patients failed to show any life-threatening risks or complications.

Level of Evidence

4. Laryngoscope, 123:2892–2895, 2013

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