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Surgery for severe obstructive sleep apnea is to be done with extreme caution.There are problems with difficult intubation, extubation from anesthetist side, rebound apnea as the Co2 drive is washed away,post op edema,laryngospam,negative pulmonary edema if any minimal aspiration and so on.The nurses who look after these patients in Jubilee hospital Trivandrum are trained to care these difficult patients.We do lot of sleep surgery in this hospital for snoring and sleep apnea.