Is It Dangerous To Have Surgery With Obstructive Sleep Apnea?

Obstructive sleep apnea or OSA is a state that develops when there is a constriction of the upper airway. It is a breathing disorder and can create a lot of dangerous complications if not treated on time. The condition varies from mild to severe and is treated according to the severity of symptoms.(1)

Is It Dangerous To Have Surgery With Obstructive Sleep Apnea?

Surgery requires anesthesia. General anesthesia, especially, can be quite hazardous for people with obstructive sleep apnea. It is because obstructive sleep apnea slows your breathing down and can increase your sensitivity towards its effects. It can also become very difficult to gain back consciousness and breathe after the surgery.

General anesthesia dominates the activity of upper airway muscles. It may harm your breathing by letting the airway to close. This may lead to an increase in the frequency and intensity of sleep apnea episodes and may reduce the level of oxygen in the blood. the intensive care should be considered as anesthesia may hamper your regaining consciousness after surgery for quite a long time.(2)

It is a known fact that if the concerned anesthesiologist knows about the patient’s history of sleep apnea, he takes appropriate measures to keep the airway unobstructed. Doing this, the dangers of giving anesthesia in people with obstructive sleep apnea can be lowered.(3)

If you have obstructive sleep apnea, it is necessary that your case is handled by a physician anesthesiologist, throughout, before and after surgery. You may need close monitoring and special medications for anesthesia, given your condition.(2)

Before your surgery is due, your doctor will perform a detailed assessment, which will include any history related to anesthesia. He will also conduct a thorough physical examination. If you need a sedative during the surgery, he will choose it utmost carefully, as sedatives also have a tendency to suppress the upper airway activity. Ensuring the proper functioning of the airway during surgery is an anesthesiologist’s first concern. If the surgery is to treat obstructive sleep apnea itself, the airway can be constricted due to inflammation and swelling, also due to processes like intubation, extubating, etc. the sedative and anesthetic together can pose a lot many difficulties post-operation. If analgesics are needed after surgery, proper ventilation, oxygenation heart rate etc. need to be monitored, as some analgesics like narcotics can further trigger a respiratory arrest. The caution taken before the surgery needs to be continued after the surgery as well.

Mechanical ventilation is needed in many cases after the surgery until they become completely awake. Those using a CPAP device will need to continue using it, with careful monitoring of pressure. Getting admitted in intensive care may be wise as you will get uninterrupted and required care.

It can be said that even if you do not require much post-operative care otherwise, it would be still wise if you stay in your doctor’s care for a few more days, as it will facilitate careful monitoring of the airway and other vitals as well.

Conclusion

Surgery in people with obstructive sleep apnea can be quite challenging. The anesthesia given during the surgery can pose great risks to people with this condition.

However, if the anesthesiologist is aware of the condition of the person and takes the required measures to keep the airway open, the dangers of giving anesthesia in people with this condition can be significantly reduced. Also, along with great pre-operative care, equal care should be given to the person during the surgery and even after the surgery, though the actual surgical procedure may not require much of post-op care. Ensuring that the person’s airway is not obstructed at any given time can minimize the risks related to anesthesia, sedatives and analgesics required before, during and after surgery.

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