Heinzer Raphaël
Service de pneumologie, Centre d'investigation et de recherche sur le sommeil, CHUV, Lausanne.
Rev Med Suisse. 2007 Nov 21;3(134):2670-4.
There are many case reports of serious complications and death among obstructive sleep apnea patients (OSA) during general anesthesia or postoperative analgesia. Sedatives and anesthetic agents, pharyngeal anatomy of these patients, opiates given for analgesia, and post operative REM sleep rebound represent potential hazards for general anesthesia in OSA patients. Ideally these patients should be treated with continuous positive airway pressure (CPAP) during premedication, directly after extubation and during postoperative analgesia. Unfortunately, only about 20% of these patients are diagnosed before surgery. A special attention should be given to the symptoms and signs suggestive of OSA during preoperative visits. Screening tests should be performed in patients with suspected OSA and, if positive, a treatment should be initiated.
有许多关于阻塞性睡眠呼吸暂停患者（OSA）在全身麻醉或术后镇痛期间出现严重并发症和死亡的病例报告。镇静剂和麻醉剂、这些患者的咽部解剖结构、用于镇痛的阿片类药物以及术后快速眼动睡眠反弹是OSA患者全身麻醉的潜在危险因素。理想情况下，这些患者在术前用药期间、拔管后即刻以及术后镇痛期间应接受持续气道正压通气（CPAP）治疗。不幸的是，这些患者中只有约20%在手术前被诊断出来。术前访视时应特别关注提示OSA 的症状和体征。对于疑似OSA的患者应进行筛查测试，如结果呈阳性，则应开始治疗。
