Assessing Risk for OSAS & Postoperative Complications

Obstructive sleep apnea syndrome (OSAS) is a disorder in which patients periodically stop breathing during sleep. Research suggests that OSAS occurs in approximately 5% to 9% of the general population, with obese men affected most often. Research also suggests that OSAS is common among patients undergoing surgery. Studies have observed an increased risk of postoperative complications in patients with OSAS when compared with control subjects. Others have demonstrated that postoperative complication rates increase as the number of episodes of overnight desaturation increase. “The related cardiorespiratory consequences may be exacerbated after surgical procedures because anesthetic agents and pain relievers decrease muscle tone in the upper airways,” explains Tajender S. Vasu, MD. “This can diminish control of breathing. As a result, it’s important to identify surgical patients who are at high risk for OSAS.” Nocturnal polysomnography is the standard for diagnosing OSAS. Home sleep testing has also gained increasing acceptance and offers advantages to nocturnal polysomnography because of convenience and cost. “Unfortunately, neither of these diagnostics is used extensively in preoperative assessment settings,” says Dr. Vasu. “Therefore, most preoperative patients with OSAS have not had their conditions diagnosed. This raises the potential for a negative effect on postoperative outcome.” The STOP-BANG Questionnaire Recently, the STOP-BANG questionnaire was validated as a screening modality for OSAS in the preoperative setting. The questionnaire—which is a mnemonic that stands for snoring, tiredness during daytime, observed apnea, high blood pressure, BMI, age, neck circumference, and gender—is a concise, self-administered, and easy-to-use questionnaire that consists of eight “yes or no” questions (Figure). A study published in the October 2010Archives of Otolaryngology–Head & Neck Surgery evaluated the clinical usefulness...