Managing Perioperative Risk
Among the dangers of sleep apnea is an increased risk of negative consequences during or following the use of sedation, analgesia, or anesthesia. The ASA is supposedly trying to help reduce the risk for patients with obstructive sleep apnea.
In order to attempt to create a guide that anesthesiologists could use to manage the risk of patients with obstructive sleep apnea, the ASA created a numerical guide that assigns points to a number of different variables, including the severity of sleep apnea, the invasiveness of the procedure, and the need for postoperative opioids to control pain. Supposedly, anesthesiologists simply add up the score to determine the need for postoperative monitoring of patients with sleep apnea.
The problem, according to Dr. Kenneth P. Rothfield, Chairman of the Department of Anesthesiology at Saint Agnes Hospital in Baltimore, is that these numbers have no scientific basis whatsoever. He also says that giving anesthesiologists and others the impression that some sleep apnea patients may not need close postoperative monitoring is dangerous and is likely to lead to adverse events and death. The reason why is that we don’t understand enough about the consequences of sleep apnea, and the potential for risk.
He even quotes the Anesthesia Patient Safety Foundation, “risk stratification for increased postoperative electronic monitoring would potentially miss a large population of patients that is at increased risk for opioid-induced respiratory depression.” The need, he stresses, is to monitor all sleep apnea patients–or, perhaps all patients–who receive opioids for pain control after surgery.
Make Sure Your Surgical Team Knows about Sleep Apnea
This is a crucial reminder that if you have sleep apnea, it’s important to make sure your surgeon, anesthesiologist, nurse, and others who are involved in your procedure and follow-up are aware of your sleep apnea and take it seriously. Failure to properly monitor you could lead to a catastrophe.
Sleep apnea treatment can also reduce your risks. If you would like to learn about sleep apnea treatment options in Omaha, please call 402-493-4175 for an appointment with a sleep dentist at the Advanced Dental Sleep Treatment Center.