Lüer-Groel B, Stasche N, Bärmann M
MVZ Westpfalz, Kaiserstr.171, 66849, Landstuhl, Deutschland.
HNO. 2012 Apr;60(4):313-7. doi: 10.1007/s00106-012-2495-0.
Obstructive sleep apnea (OSA) has a relatively high prevalence of 3-7% in the general population in western industrialized countries. The prevalence is higher in older patients and in patients with cardiac or metabolic disorders. In the general surgical population patients with OSA are often unrecognized prior to surgery so that unexpected problems can occur due to the higher risk of airway collapse. Severe apnea can result even hours later and especially after surgery of the upper airway. Anesthesists and ear nose and throat surgeons are equally responsible for the perioperative surveillance. The article will show the importance of the preoperative identification of OSA patients and the perioperative risk management in the different risk phases apart from surgery. Although the importance of guidelines is very high there are no mandatory guidelines in Germany in contrast to the USA and the implementation should be given priority.
在西方工业化国家的普通人群中,阻塞性睡眠呼吸暂停(OSA)的患病率相对较高,为3%至7%。老年患者以及患有心脏或代谢紊乱的患者中患病率更高。在普通外科手术人群中,OSA患者在手术前常常未被识别,因此由于气道塌陷风险较高,可能会出现意想不到的问题。严重的呼吸暂停甚至可能在数小时后出现,尤其是在上呼吸道手术后。麻醉医生和耳鼻喉科医生对围手术期监测负有同等责任。本文将阐述除手术外,术前识别OSA患者的重要性以及在不同风险阶段的围手术期风险管理。尽管指南非常重要,但与美国不同,德国没有强制性指南,应优先考虑实施。