Weinberg Laurence, Tay Stan, Lai Chung Fei, Barnes Maree
Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia.
BMJ Case Rep. 2013 Jan 30;2013:bcr2012008336. doi: 10.1136/bcr-2012-008336.
Despite the increasing prevalence of obstructive sleep apnoea (OSA), there is limited evidence to guide appropriate preoperative investigations, inpatient or outpatient surgery allocation, and the anticipated level of postoperative care. With reference to our institution's perioperative risk stratification, we describe the case of a 46-year-old Caucasian male with a body mass index of 51 kg/m(2) admitted for laparoscopic band insertion. Management based on our guidelines involved a preoperative polysomnography where the patient was confirmed to have severe OSA. His postoperative care was then managed in the high dependency care unit. He was discharged home on day 2 with no further sequelae. We provide evidence that adoption of this model of care can simplify clinical decision making and resource allocation with favourable patient outcomes.
尽管阻塞性睡眠呼吸暂停(OSA)的患病率日益上升,但指导进行适当的术前检查、住院或门诊手术安排以及术后预期护理水平的证据有限。参照我们机构的围手术期风险分层,我们描述了一例体重指数为51kg/m²的46岁白种男性因腹腔镜束带置入入院的病例。基于我们的指南进行的管理包括术前多导睡眠图检查,结果证实该患者患有严重OSA。随后他在高依赖护理病房接受术后护理。他于第2天出院,无进一步后遗症。我们提供的证据表明,采用这种护理模式可以简化临床决策和资源分配,并取得良好的患者预后。