The syndrome of OSA is characterized by repetitive episodes of upper airway obstruction during sleep which may be accompanied by sleep disruption, hypoxemia, and arterial oxygen desaturation. Obstruction or anatomic narrowing can occur at one or more points in the upper airway and may be due to a variety of factors including abnormal neuromuscular tone, redundant soft tissue or an increase in upper airway adipose tissue. Classical OSA patients tend to be obese. However, non-obese patients can have OSA from tonsillar hypertrophy or craniofacial abnormalities.
Prolonged arterial oxygen desaturation leads to secondary cardiac and lung abnormalities including systemic and pulmonary hypertension, cardiac rhythm disturbances and, in extreme cases, right ventricular failure which is known as corpulmonale. Therefore, the first step in successfully anesthetizing an OSA patient is to conduct a thorough preoperative assessment. Safe anesthetic care can be provided by thorough preoperative assessment, a thoughtful and well-executed anesthetic plan, and vigilance which extends well into the postoperative period.
Induction is the most challenging issue facing the anesthetist.
Here a 39 year old lady from Mumbai undergoes Sleep surgery in Jubilee Hospital, Trivandrum, South India. She suffers from severe Obstructive Sleep Apnea (OSA) with oxygen level below 50% saturation while sleeping. Sleep Surgery is done using RF Coblator in By Dr.K.O.Paulose FRCS, Consultant ENT Surgeon.Dr.Thomas, the Senior Anesthetist intubate the patient for General Anesthesia.
