Sleep apnoea increases risks in general anaesthesia

Patients with obstructive sleep apnoea are at high risk of developing complications when having surgery under general anaesthesia, say researchers in this week's BMJ.

People with sleep apnoea temporarily stop breathing for 10 seconds or more during sleep. The typical sufferer is overweight and a heavy snorer. Obstructive sleep apnoea is the most common type, affecting 2% of women and 4% of men in middle age.

Surgeons of all specialties, and particularly anaesthetists, should be aware that obstructive sleep apnoea is undiagnosed in an estimated 80% of patients, say the authors. They should be alert to patients who are at risk of having obstructive sleep apnoea and be aware of the potential complications before and after surgery, even for surgery not related to the condition.

Options that should be considered include alternative methods of pain relief, use of nasal continuous positive airway pressure before and after surgery, and surveillance in an intensive care unit, especially after nasal surgery, conclude the authors.

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