post op protocol for patients with sleep apnea.  How long patients with sleep apnea should be watched post operatively.

Until anesthesia has been fully resolved. Then try to get CPAP on them ASAP in the hospital course, to help them sleep and ultimately, heal.

For general anesthesia, CPAPs should be used immediately after surgery in the recovery room.  CPAPs should be used thoughout the procedure if conscious sedation is used.  Please read these manuals found at the ASAA main site which covers this in detail:

CPAP USE IN A HOSPITAL OR SURGICAL SETTING
HOSPITAL CHECKLIST FOR OBSTRUCTIVE SLEEP APNEA PATIENTS
SLEEP APNEA AND SAME-DAY SURGERY

The link to these documents is here.  Scroll down to the "Surgery" Heading:

http://www.sleepapnea.org/resources/pubs.html

Post back with any questions.  Hope it goes well!!

Vicki


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Being defeated is often a temporary condition. Giving up is what makes it permanent.
Marilyn Von Savant

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

Hi Vic.....I took the question to mean general anesthesia. I'd be a little bit leery of puttinf a CPAP on a freshly extubated postop pt. Usually after extubation they get a big ol' dose of 100% O2, anyway. Once they "wake up" a bit, tho (IE could remove mask if nausea occurs, etc), CPAP could be applied.

My husband had rotator cuff surgery in March 2007 and was kept in the hospital overnight for pain management.  Neither a CPAP nor monitoring was used and he died during the night.  The combination of sleep apnea, anesthesia and opiad drugs (morphine and dilaudid) were the causes.  He was not being monitored nor given any type of oxygen.

Sleep apnea patients should be monitored closely and given alternative pain meds.  My husbands death was 100% preventable if he had been monitored.

Wow, this is great info to know as it's always possible I'll have eye surgery someday again....

Is concious sedation better than general anesthesia when both are an option? I chose in the past to go under general for my glaucoma surgeries, but won't do it again if conscious sedation is less complicating for someone with OSA.


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Mom of two sweet girls, a 1.5yo and a 5yo
Started CPAP 10/22/07
ResMed Autoset II with Humidaire 3i, Pressure 7-12
ResMed Mirage Quattro FF Mask

Yes, concious sedation is inherently safer, because you're not so "snowed under" by meds that you can't breathe under your own power (unlike general anesthesia, where a ventilator has to breathe for you). Obstructive apneas can be MUCH MUCH worsened while under concious sedation, though. Before any procedure, disclose that you have OSA to the surgeon, anesthesist, nurse,........and anybody else you can find. Better safe than sorry.

I was just diagnosed with sa last week. I had knee surgery in december. I had general anesthesia. Doctor did not say that i had any problems breathing but it does make me wonder.

PATL,  I am so sorry to hear of your loss.  If you have  not done so already, please share this inother areas on the forum...it is eye opening information.

God's Peace


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I am A ZOMBIE! 20 years+ undx'd. BiPAP Auto M 14/9. Nasal Swift&F&P Flex Fit 431 Full Face. RLS/PLMD, Primary CNS Hypersomnia, Sleep Paralysis, Parasomnia, Degenerative Disc Disease, Clinical MS, Fibromyalgia, COPD plus other past dx's..what's next?