Obstructive sleep apnea in surgical patients and its relationship with difficult intubation: two years of experience from a single center
Apneia obstrutiva do sono em pacientes cirúrgicos e sua relação com intubação difícil: experiência de dois anos em um único centro
Volkan Ozen, Nurten Ozen
Abstract
Background and objectives
In this study, we aimed to determine the risk of obstructive sleep apnea (OSA) in patients undergoing elective surgery and its relationship with difficult intubation (DI).
Methods
This prospective, descriptive cross-sectional study was conducted between December 2018 and February 2020 in the anesthesiology and reanimation service of a training and research hospital. The study included patients who were ASA I–II, 18 years of age and older who underwent elective surgery under general anesthesia. A form regarding the baseline characteristics of the participants as well as STOP-Bang score, Mallampati, and Cormack-Lehane classification was used to collect the data.
Results
The study included 307 patients. It was determined that 64.2% of patients had a high risk of OSA. The presence of DI (determined by repeated attempts at intubation) was 28.6% in the high-risk OSA group, while there was no DI in the low-risk OSA group. A statistically significant difference was found between the groups in terms of OSA risk according to the presence of DI according to repeated attempts, Cormack-Lehane classification, and Mallampati classification (p < 0.001).
Conclusion
Due to the high rate of DI in patients with a high risk of OSA, the security of the airway in these patients is endangered. Early clinical recognition of OSA can help in designing a safer care plan.
Keywords
Resumo
Introdução
Neste estudo, objetivamos determinar o risco de apneia obstrutiva do sono (AOS) em pacientes submetidos a cirurgia eletiva e sua relação com intubação difícil (ID).
Métodos
Este estudo prospectivo, descritivo e transversal foi realizado entre dezembro de 2018 e fevereiro de 2020 no serviço de anestesiologia e reanimação de um hospital de ensino e pesquisa. O estudo incluiu pacientes ASA I–II, com idade igual ou superior a 18 anos, submetidos a cirurgia eletiva sob anestesia geral. Um formulário sobre as características basais dos participantes, bem como a pontuação STOP-Bang, Mallampati e classificação de Cormack-Lehane foi usado para coletar os dados.
Resultados
O estudo incluiu 307 pacientes. Foi determinado que 64,2% dos pacientes tinham alto risco de AOS. A presença de ID (determinada por tentativas repetidas de intubação) foi de 28,6% no grupo AOS de alto risco, enquanto não houve ID no grupo AOS de baixo risco. Foi encontrada diferença estatisticamente significativa entre os grupos quanto ao risco de AOS segundo a presença de ID segundo tentativas repetidas, classificação de Cormack-Lehane e classificação de Mallampati (p<0,001).
Conclusão
Devido à alta taxa de ID em pacientes com alto risco de AOS, a segurança das vias aéreas nesses pacientes está ameaçada. O reconhecimento clínico precoce da AOS pode ajudar na elaboração de um plano de cuidados mais seguro.
Palavras-chave
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