ICU May Not Be Needed After Sleep Apnea
MONDAY, March 19 (HealthDay News) -- After undergoing surgery
for obstructive sleep apnea, patients require close monitoring but
may not need to be in an intensive care unit, according to a new
Obstructive sleep apnea is a disorder in which a person
experiences abnormal pauses in breathing while they sleep. Sleep
apnea can put people at risk of high blood pressure, stroke and
Treatments include losing weight and continuous positive airway
pressure (CPAP) devices, although some people may need surgery.
The surgery itself carries risks, however, the experts note.
These include post-operative breathing difficulties, so patients
are often placed in ICUs afterward.
But is that always necessary? To find out, researchers at the
Pacific Sleep Centre in Singapore reviewed the cases of nearly 500
sleep apnea patients who had surgery between early 2007 and
mid-2010. The surgeries included nasal, palate and tongue
The overall complication rate was 7 percent, according to the
study, which appears online March 19 in the
Archives of Otolaryngology -- Head & Neck Surgery.
Patients who undergo surgery for sleep apnea will end up with
small lower jaws, making airway access difficult for
anesthesiologists, the researchers noted. Another risk is
dangerously slowed breathing due to anesthetics such as muscle
relaxants and narcotics.
While routine admission to the ICU may not be necessary for all
patients who've just had sleep apnea surgery, all patients should
be closely monitored in the recovery or high-dependency area (one
step below intensive care) for at least 3 hours after surgery, the
"In conclusion, we strongly recommended that the clinician manage the patient with OSA [obstructive sleep apnea] with caution and prudence, with the understanding that these patients have a higher risk of airway compromise and respiratory depression intraoperatively and postoperatively," they wrote.
Dr. Lisa Liberatore, an ear, nose and throat specialist at Lenox
Hill Hospital in New York City, said sleep apnea patients often
have other medical issues that may raise surgical risks.
Because of the risks, surgeons should proceed with caution and
patients should first try other, non-surgical treatments, she
"I recommend that the patient use CPAP first and lose at least 20 to 30 pounds before doing any surgery," Liberatore said.
The U.S. National Heart, Lung, and Blood Institute has more
sleep apnea treatment.
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