Prevention and management of perioperative complications of obstructive sleep apnea-hypopnea syndrome

Objective To explore the prevention and management of complications during the perioperative period of obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Clinical data of 98 patients with OSAHS were analyzed retrospectively.The patients with hypertension,diabetes and cardiac diseases were all treated before uvulapalatopharyngoplasty(UPPP).UPPP was performed under general anesthesia in 81 cases(82.7%) and under local anesthesia in 17 cases(17.3%).Tracheotomy was performed in 36 cases simultaneously or one week before UPPP.Results The heart rate and blood oxygen saturation decreased dramatically in 1 case as tracheotomy was being performed under local anesthesia,and UPPP was then performed when the general condition was stabilized.Respiratory restraint appeared in 1 case after tracheal tube was excubated,and emergent tracheal reintubation combined with artificial respiration was given with successful outcome.The hemostasia was performed under general anesthesia in 1 case owing to bleeding after UPPP.Conclusion More attention should be paid to the preoperative examinations in patients with OSAHS,and systemic disorders should be treated promptly as to reduce or even avoid the cardiovascular and cerebrovsacular complications during and after operation.For the patients receiving UPPP under general anesthesia,tracheal excubation should be done when they completely aroused.To reduce severe complications,tracheotomy is recommended to the obese patients or those with the lowest blood oxygen saturation(50%),those with severe cardiovascular diseases,and those with the nasal operation performed synchronously.