What kind of precautions are used for people with sleep apnea who require sugery in which a general anethesia is required? I hav had cervical surgery in the past, and will possibly need it again. The first time was before I begain CPAP and while in recovery I had problems breathing. I actually came out of anethesia gasping for breath, trying to get oxygen. The nurse informed me that I had been experiencing difficulty while I was under. Please tell me what is usually done for sleep apnea patients who are condidates for surgical procedures.

Guest,

Make a consultation appointment with your anesthesiologist and tell them.  Most hospitals have a policy of allowing patients to bring their own equipment with them.  It will go with you into surgery so that it can be used in recovery.  People are intubated (breathing tube put down your throat) when general anesthesia is used.  Apnea patients can be a little more difficult for the anesthesiologist because as we lose consciousness, our airways collapse.

Usually your personal CPAP will have to be cleared through the hospital's engineering or instrumentation department to make sure it is running properly and doesn't spark, so make sure you get it cleared a day or two before surgery.

Most importantly, and I reiterate, spend some time going over your condition with your anesthesiologist.  If you can't bring in your own equipment, at least take your hose and mask.

You might consider registering.  It is free and you get more forum perks.

Vicki


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That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

After my sleep apnea diagnosis, I've had sedation or anesthesia three times (none related to OSA!), each at a different hospital.  Each experience was different:
 
They put a tube down my throat during my sinus surgery.  I didn't need my CPAP equipment at the hospital at all.  Other than throat irritation from the tube, it went well.  I discussed it with the anesthesiologist before surgery.
 
Another time, I was only lightly sedated and awake during the procedure.  However, I had to stay overnight in the hospital.  I brought and used my CPAP during the night (it was "interesting," as I had to be on oxygen, too, due to my pain pump).  I didn't have to prove to them that my CPAP machine was "OK."  
 
The most recent time, I was more heavily sedated.  The anesthetist said she'd try to keep me as lightly sedated as she could, to prevent my airway from collapsing, but if she couldn't, she'd use a tube down my throat.  I didn't need the tube (hooray!).  I recovered very quickly and had no problems.
 
Bottom line: each case is different; each hospital is different.  You might not need an appointment with the anesthesiologist, but you will need to let the hospital know about your sleep apnea and discuss it with the anesthesiologist before your surgery.
 
Good luck!
 
- Ridge Runner

Anonymous wrote:

What kind of precautions are used for people with sleep apnea who require sugery in which a general anethesia is required? I hav had cervical surgery in the past, and will possibly need it again. The first time was before I begain CPAP and while in recovery I had problems breathing. I actually came out of anethesia gasping for breath, trying to get oxygen. The nurse informed me that I had been experiencing difficulty while I was under. Please tell me what is usually done for sleep apnea patients who are condidates for surgical procedures.

Hi,

You need to talk to the anaesthetist and explain that you have OSA. If he gives you a blank look, go elsewhere.

Most anaesthetists are familiar with OSA patients and would normally intubate you during the procedure. Any difficulties usually arise in the recovery room, as you are still under the influence of a mix of drugs and breathing on your own (as distinct from being controlled while in the ER). Most cases I have heard of you will bring your cpap machine with you and the nurses in recovery will put your mask on you and start the machine.

On the plus side, I haven't heard of any major problems.

Daniel.


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The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

I have Central Sleep Apnea and they were even more cautious then if it had been OSA. I was not given anything to relax me in Pre-op- most of the time they you something there and I even had one anesthesiologist years ago who put something in my IV to knock me completely out before I got to the OR. It was a little unusual to be fully with it and having the anesthesiologist trying to start my IV while a couple other people were doing other things to me. Before they even started any meds through my IV, they had put a breathing mask on me and intubated me as soon as I was out. They woke me up while I was still in the OR- the breathing tube came out as I was waking up. Typically they take the tube out and you don't really wake up until you've been in recovery for a little while- I kind of felt the only sorber person at a bar in recovery as the other patients were waking up- its kind of funny to hear what some people say when they're pretty drugged up. Pain meds were given in several small doses instead of one large one in recovery. Another precaution was that they had an anesthesiologist plus they pulled one of the nurse anesthestist in so they had two people in case there were any problems with my breathing. Considering the surgery I had was very minor & only took 20 minutes, in most cases they probably would have used the ballon thing at the back of the throat instead of a full intubation.

I was able to go home within a couple hours of surgery though I did make sure my friend was with when I was back on the post op unit just in case I fell asleep. In recovery, they have you hooked up to a lot of monitors but after that it can really varry depending on what you had done & the hospital. I was in the hospital for something else last year, and I did have to use their machine the first night- it was an unexpected hospitalization. My family was able to bring my BiPAP ST in the next day so I could use my own. The only thing I had to do is make sure I let the nurses know I needed distilled water for my humidifier. One nurse was a hose head herself, so she filled the humidifier for me which was nice. I will say I was much more careful about making sure my mask was washed every night- there are just too many germs on various surfaces in hospitals that you really don't want in your nose or on your face.