Patients with obstructive sleep apnea (OSA) are at an increased risk for perioperative and postoperative complications after receiving intravenous (IV) sedation or postoperative analgesia. We previously showed that most oral and maxillofacial surgery (OMS) providers do not screen for OSA using a quantifiable method. The purpose of this study was to determine the prevalence of OSA risk in the OMS office-based anesthesia patient population using the snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and gender (STOP-BANG) questionnaire.
After deeming patients (n = 153) suitable for outpatient IV sedation using our existing institutional ambulatory preanesthesia protocol, 2 OMS providers administered the STOP-BANG questionnaire to classify patient risk for OSA. The questionnaire is a concise, validated predictor for OSA risk and consists of 8 yes or no questions.
Of the 153 patients, 141 (92.16%) were at a low risk for moderate to severe OSA, 11 (7.19%) were at a moderate risk, and 1 (0.65%) was at a high risk. Overall, 12 (7.84%) patients were shown to be at risk for OSA. We estimate with 95% confidence that between 5.7 and 10% of all OMS office-based anesthesia patients are at risk for OSA. The IV sedation plans for 4 (2.61%) patients were changed after including OSA risk with the existing preanesthesia protocol.
A statistically significant proportion (95% confidence interval, 0.0567 to 0.100) of the OMS office-based anesthesia patient population is at an increased risk for moderate to severe OSA. These results outline the importance of screening for OSA before office-based anesthesia administration. OMS providers can easily use the STOP-BANG questionnaire to assess OSA risk, modify anesthesia management, and improve patient safety.
Copyright © 2020. Published by Elsevier Inc.