Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome
Introduction: Patients with STOP-BANG score >3 have a high risk of Obstructive sleep apnea. The aim of this study was to evaluate early postoperative respiratory complications in adults with STOP-BANG score >3 after general anesthesia. Methods: This is a prospective double cohort study matchin...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2015-09-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001414000268 |
| _version_ | 1811201559208394752 |
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| author | Daniela Xará Júlia Mendonça Helder Pereira Alice Santos Fernando José Abelha |
| author_facet | Daniela Xará Júlia Mendonça Helder Pereira Alice Santos Fernando José Abelha |
| author_sort | Daniela Xará |
| collection | DOAJ |
| description | Introduction: Patients with STOP-BANG score >3 have a high risk of Obstructive sleep apnea. The aim of this study was to evaluate early postoperative respiratory complications in adults with STOP-BANG score >3 after general anesthesia. Methods: This is a prospective double cohort study matching 59 pairs of adult patients with STOP-BANG score >3 (high risk of obstructive sleep apnea) and patients with STOP-BANG score <3 (low risk of obstructive sleep apnea), similar with respect to gender, age and type of surgery, admitted after elective surgery in the Post-Anaesthesia Care Unit in May 2011. Primary outcome was the development of adverse respiratory events. Demographics data, perioperative variables, and postoperative length of stay in the Post-Anesthesia Care Unit and in hospital were recorded. The Mann–Whitney test, the chi-square test and the Fisher exact test were used for comparisons. Results: Subjects in both pairs of study subjects had a median age of 56 years, including 25% males, and 59% were submitted to intra-abdominal surgery. High risk of obstructive sleep apnea patients had a higher median body mass index (31 versus 24 kg/m2, p < 0.001) and had more frequently co-morbidities, including hypertension (58% versus 24%, p < 0.001), dyslipidemia (46% versus 17%, p < 0.001) and insulin-treated diabetes mellitus (17% versus 2%, p = 0.004). These patients were submitted more frequently to bariatric surgery (20% versus 2%, p = 0.002). Patients with high risk of obstructive sleep apnea had more frequently adverse respiratory events (39% versus 10%, p < 0.001), mild to moderate desaturation (15% versus 0%, p = 0.001) and inability to breathe deeply (34% versus 9%, p = 0.001). Conclusion: After general anesthesia high risk of obstructive sleep apnea patients had an increased incidence of postoperative respiratory complications. Resumo: Justificativa e objetivo: Os pacientes com escore STOP-BANG > 3 possuem alto risco de desenvolver apneia obstrutiva do sono. O objetivo deste estudo foi avaliar as complicações respiratórias no pós-operatório imediato em adultos com escore STOP-BANG > 3 após anestesia geral. Métodos: Estudo prospectivo de dupla-coorte, comparando 59 pares de pacientes adultos com escore STOP-BANG > 3 (alto risco de apneia obstrutiva do sono) e pacientes com escore STOP-BANG < 3 (baixo risco de apneia obstrutiva do sono), similares no que diz respeito ao gênero, idade e tipo de cirurgia, admitidos após a cirurgia eletiva em sala de recuperação pós-anestésica (SRPA) em maio de 2011. O desfecho primário foi o desenvolvimento de eventos respiratórios adversos. Dados demográficos, variáveis no perioperatório e tempos de permanência na SRPA e no hospital após a cirurgia foram registrados. Os testes de Mann-Whitney, qui-quadrado e exato de Fisher foram usados para comparação. Resultados: Os indivíduos de ambos os grupos de pacientes do estudo tinham uma média de idade de 56 anos, 25% eram do sexo masculino e 59% foram submetidos à cirurgia intra-abdominal. Os pacientes com alto risco de apneia obstrutiva do sono apresentavam uma mediana maior do índice de massa corporal (31 versus 24 kg/m2, p < 0,001) e comorbidades mais frequentes, como hipertensão (58% vs. 24%, p < 0,001), dislipidemia (46% vs. 17%, p < 0,001) e diabetes melito dependente de insulina (17% vs. 2%, p = 0,004). Esses pacientes foram submetidos com mais frequência à cirurgia bariátrica (20% vs. 2%, p = 0,002). Os pacientes com alto risco de apneia obstrutiva do sono apresentaram mais eventos respiratórios adversos (39% vs. 10%, p < 0,001), dessaturação de leve a moderada (15% vs. 0%, p = 0,001) e incapacidade de respirar profundamente (34% vs. 9%, p = 0,001). Conclusões: Após a anestesia geral, os pacientes com alto risco de apneia obstrutiva do sono apresentaram um aumento da incidência de complicações respiratórias no período pós-operatório. Keywords: Obstructive sleep apnea, Respiratory events, Postoperative outcome, Palavras-chave: Apneia obstrutiva do sono, Eventos respiratórios, Desfecho no pós-operatório |
| first_indexed | 2024-04-12T02:23:38Z |
| format | Article |
| id | doaj.art-c395711161084a8bb607637dab1fc687 |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-12T02:23:38Z |
| publishDate | 2015-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-c395711161084a8bb607637dab1fc6872022-12-22T03:52:04ZengElsevierBrazilian Journal of Anesthesiology0104-00142015-09-01655359366Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndromeDaniela Xará0Júlia Mendonça1Helder Pereira2Alice Santos3Fernando José Abelha4Department of Anaesthesiology, Centro Hospitalar de São João, Porto, PortugalDepartment of Anaesthesiology, Centro Hospitalar de São João, Porto, PortugalDepartment of Anaesthesiology, Centro Hospitalar de São João, Porto, PortugalDepartment of Anaesthesiology, Centro Hospitalar de São João, Porto, PortugalDepartment of Anaesthesiology, Centro Hospitalar de São João, Porto, Portugal; Anaesthesiology and Perioperative Care Unit, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Surgical Department of Faculty of Medicine, University of Porto, Portugal; Corresponding author.Introduction: Patients with STOP-BANG score >3 have a high risk of Obstructive sleep apnea. The aim of this study was to evaluate early postoperative respiratory complications in adults with STOP-BANG score >3 after general anesthesia. Methods: This is a prospective double cohort study matching 59 pairs of adult patients with STOP-BANG score >3 (high risk of obstructive sleep apnea) and patients with STOP-BANG score <3 (low risk of obstructive sleep apnea), similar with respect to gender, age and type of surgery, admitted after elective surgery in the Post-Anaesthesia Care Unit in May 2011. Primary outcome was the development of adverse respiratory events. Demographics data, perioperative variables, and postoperative length of stay in the Post-Anesthesia Care Unit and in hospital were recorded. The Mann–Whitney test, the chi-square test and the Fisher exact test were used for comparisons. Results: Subjects in both pairs of study subjects had a median age of 56 years, including 25% males, and 59% were submitted to intra-abdominal surgery. High risk of obstructive sleep apnea patients had a higher median body mass index (31 versus 24 kg/m2, p < 0.001) and had more frequently co-morbidities, including hypertension (58% versus 24%, p < 0.001), dyslipidemia (46% versus 17%, p < 0.001) and insulin-treated diabetes mellitus (17% versus 2%, p = 0.004). These patients were submitted more frequently to bariatric surgery (20% versus 2%, p = 0.002). Patients with high risk of obstructive sleep apnea had more frequently adverse respiratory events (39% versus 10%, p < 0.001), mild to moderate desaturation (15% versus 0%, p = 0.001) and inability to breathe deeply (34% versus 9%, p = 0.001). Conclusion: After general anesthesia high risk of obstructive sleep apnea patients had an increased incidence of postoperative respiratory complications. Resumo: Justificativa e objetivo: Os pacientes com escore STOP-BANG > 3 possuem alto risco de desenvolver apneia obstrutiva do sono. O objetivo deste estudo foi avaliar as complicações respiratórias no pós-operatório imediato em adultos com escore STOP-BANG > 3 após anestesia geral. Métodos: Estudo prospectivo de dupla-coorte, comparando 59 pares de pacientes adultos com escore STOP-BANG > 3 (alto risco de apneia obstrutiva do sono) e pacientes com escore STOP-BANG < 3 (baixo risco de apneia obstrutiva do sono), similares no que diz respeito ao gênero, idade e tipo de cirurgia, admitidos após a cirurgia eletiva em sala de recuperação pós-anestésica (SRPA) em maio de 2011. O desfecho primário foi o desenvolvimento de eventos respiratórios adversos. Dados demográficos, variáveis no perioperatório e tempos de permanência na SRPA e no hospital após a cirurgia foram registrados. Os testes de Mann-Whitney, qui-quadrado e exato de Fisher foram usados para comparação. Resultados: Os indivíduos de ambos os grupos de pacientes do estudo tinham uma média de idade de 56 anos, 25% eram do sexo masculino e 59% foram submetidos à cirurgia intra-abdominal. Os pacientes com alto risco de apneia obstrutiva do sono apresentavam uma mediana maior do índice de massa corporal (31 versus 24 kg/m2, p < 0,001) e comorbidades mais frequentes, como hipertensão (58% vs. 24%, p < 0,001), dislipidemia (46% vs. 17%, p < 0,001) e diabetes melito dependente de insulina (17% vs. 2%, p = 0,004). Esses pacientes foram submetidos com mais frequência à cirurgia bariátrica (20% vs. 2%, p = 0,002). Os pacientes com alto risco de apneia obstrutiva do sono apresentaram mais eventos respiratórios adversos (39% vs. 10%, p < 0,001), dessaturação de leve a moderada (15% vs. 0%, p = 0,001) e incapacidade de respirar profundamente (34% vs. 9%, p = 0,001). Conclusões: Após a anestesia geral, os pacientes com alto risco de apneia obstrutiva do sono apresentaram um aumento da incidência de complicações respiratórias no período pós-operatório. Keywords: Obstructive sleep apnea, Respiratory events, Postoperative outcome, Palavras-chave: Apneia obstrutiva do sono, Eventos respiratórios, Desfecho no pós-operatóriohttp://www.sciencedirect.com/science/article/pii/S0104001414000268 |
| spellingShingle | Daniela Xará Júlia Mendonça Helder Pereira Alice Santos Fernando José Abelha Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome Brazilian Journal of Anesthesiology |
| title | Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome |
| title_full | Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome |
| title_fullStr | Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome |
| title_full_unstemmed | Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome |
| title_short | Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome |
| title_sort | adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome |
| url | http://www.sciencedirect.com/science/article/pii/S0104001414000268 |
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