Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Where We Are Indexed
Past Issue Archives
Clinical Communication
In Review
Editorial Board
Information for Authors
Author Form

Reprints, Permissions, & Copyright
Site Map
BACK ISSUE articles are $15 each.
International credit cards NOT accepted.

JCOM Paid Subscribers
user name:
Forgot password?

JCOM Abstract

J Clin Outcomes Manage 
2011 Sep;18(9):399-411
Perioperative screening for the management of patients with obstructive sleep apnea
Sundar E, Chang J, Smetana GW

Abstract: Objective: To provide a comprehensive review of studies related to screening for and perioperative management of patients with possible obstructive sleep apnea (OSA). Methods: We conducted a MEDLINE search for publications related to the incidence and morbidity of OSA, screening for OSA in perioperative patients, effects of anesthesia on OSA and the anesthetic management of patients with OSA. A manual search of bibliographies was undertaken. Results: Anesthesia and surgery are associated with loss of rapid eye movement (REM) sleep and subsequent rebound associated with exacerbation of OSA-related symptoms. Narcotic analgesics, muscle relaxants, and cholinesterase inhibitors also exacerbate OSA. OSA confers higher rates of perioperative airway management difficulties and traditional postoperative pulmonary complications. Available screening tools are described. An algorithm for the postanesthetic management of screen-positive patients that reduces the need for continuous monitoring and continuous positive airway pressure (CPAP) application is proposed. Conclusion: OSA is an important risk factor for perioperative medical complications. While screening tools for OSA in the perioperative populations have methodological deficiencies including high rates of false-positives leading to heavy resource utilization, we recommend their use before major noncardiac surgery.

Clinical Review Article

Search the Turner White index to find abstracts of articles published in JCOM.

New issues are posted one month following publication of the printed journal.

View past issue archives:    2013    2012    2011    2010    2009    2008    2007
   2006    2005    2004    2003     2002     2001     2000     1999

Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2018, Turner White Communications
Updated 1/20/14 • jdw