A Pre-Operative Test Can Warn of Post-Op Complications

If you’re known to have Obstructive Sleep Apnea Syndrome (OSAS) you’re more likely to have respiratory problems after surgery involving general anesthesia.  The trouble is that some cases of OSAS are ‘hidden’; that’s to say they haven’t been diagnosed by a physician because the symptoms haven’t caused sufficient trouble for you to report them.  Philadelphia physicians have developed a questionnaire to help diagnose hidden OSAS pre-operatively, to help prepare for possible post-op complications.  They tested their questionnaire, and reported the findings in the Archives of Otolaryngology - Head and Neck Surgery.

The patients in the study were adults undergoing elective surgery; they were administered the 8-item questionnaire during a 3-day period in May 2008. Their average age was 58, and 44% were men.  The questionnaire comprised yes/no answers to questions about snoring, daytime tiredness, observed apnea (absent breathing periods), blood pressure, age, gender, BMI, and neck circumference.  

A total of 135 patients were included in the study.  Of these, 45% were found to have a high risk for OSAS, based on the questionnaire.  And these patients were more likely to develop postoperative complications – seen in 19.6%, compared with 1.3% in the patients with low scores on the questionnaire.  They also had significantly longer stays in hospital – 3.6 days, on average, vs. 2.1 days for the low-scorers. 

Obstructive sleep apnea is a serious sleep disorder that occurs when someone’s breathing is interrupted during sleep, due to a blockage of the airway when the soft tissue in the back of the throat collapses during sleep.  Snoring is common.  OSAS is usually seen in overweight men over 40, usually having a large neck size, or large tonsils.  It may result in high blood pressure, stroke, heart failure or irregular beats, heart attacks and diabetes.  So it’s not something to be taken lightly.  Taking the preoperative questionnaire seems a good way to find out if someone has OSAS without realizing it, as ‘forewarned is forearmed’.