Post Operative Care After Sleep Surgery:Be Cautious

Patients who undergo surgery for obstructive sleep apnea may not require admission to an intensive care unit (ICU) after surgery; they should still be closely monitored in a high dependency post of care ward.These type of patients suffering with sleep apnea are at higher risk for airway compromise after surgery, surgical procedures were usually considered dangerous and potentially fatal if the patient was not closely monitored.
Patients with OSA typically have small retrognathic mandibles with difficult airways and, hence, present as difficult intubations to the anesthesiologists. In addition, respiratory depression from anesthetic agents like muscle relaxants and narcotics are well documented in these patients.
All our patients are closely monitored for at least 6-12 hours after surgery in the post op recovery or high-dependency area (step-down care from ICU).
I strongly recommended that the surgeons managing the patient with OSA be cautious , with the understanding that these patients have a higher risk of airway compromise and respiratory depression intraoperatively and post operatively.
For Anesthetists it can be a challenge in dealing with these type of patients. There are problems with difficult intubation, difficult extubation, rebound apnea as the Co2 drive is washed away, post op laryngeal and throat edema, laryngospasam, negative pressure 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.