Association Between Obstructive Sleep Apnea and Postoperative Adverse Events
Schultz, Mary Pat
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Purpose: Adults with obstructive sleep apnea (OSA) arouse from sleep repeatedly due to hypoxemia and hyerpcapnea. General anesthesia, analgesics, and sedatives may interfere with these arousals and, thus, increase adverse events. Therefore, the purpose of this study is to compare postoperative recovery scores in adult surgical patients with and without diagnosed OSA. Significant differences in postoperative recovery scores between these groups may suggest an opportunity to improve patient care in the postoperative environment. Methods: We performed a retrospective electronic data review to compare postoperative recovery scores in two matched cohorts of patients admitted to a large urban medical center between November 2009 and July 2011 for procedures requiring anesthesia. OSA and non-OSA cohorts were matched based on gender, age, and type of surgical procedure. We collected data regarding patients' post-anesthesia recovery scores in four categories: oxygen saturation, respiration rate, blood pressure, and level of consciousness. Results: Our cohorts included 61 people with an ICD-9 code for OSA and 55 people who did not have an OSA diagnosis. We noted no significant differences in mean post-anesthesia recovery scores between the two cohorts in each of the four categories. We did find a significant difference (p = .05) between the number of assessments the OSA cohort received (M= 5.80, SD = 2.52) and the number of assessments the non-OSA cohort received (M=4.87, SD= 2.62). We also found that the OSA cohort's mean initial scores upon arrival to the post-anesthesia care unit (PACU) were significantly better for respiration (p = .05) and level of consciousness (p = .03) than were the non-OSA cohort's scores. Conclusions: While the OSA cohort received better initial recovery scores upon arrival to the post anesthesia care unit (PACU), they had a higher number of assessments overall, indicating that they spent more time on the PACU before discharge. Numerous explanations exist to explain these results, indicating a need for further research.
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