Ambrosii Tatiana, Şandru Serghei, Belîi Adrian
State University of Medicine and Pharmacy "Nicolae Testemiţanu", Republic of Moldova.
Rom J Anaesth Intensive Care. 2016 Oct;23(2):103-110. doi: 10.21454/rjaic.7518/232.pec.
Patients with obstructive sleep apnoea (OSA) have a high risk of postoperative complications. The purpose of the study was to record the spectrum and frequency of postoperative complications in patients with OSA without OSA depending on the type of surgery and type of anaesthesia in a large cohort of patients.
We conducted a prospective, descriptive study (n = 400). Ethics Committee approval was obtained and written informed consent was signed. The Berlin screening questionnaire was used for OSA screening (77.2% - OSA [+]). Adverse events and complications were recorded postoperatively (AOS [+] s. AOS [-]). Statistics: Chi square test.
The highest rate of complications was found in patients who had underwent surgery in the abdominal cavity under general anaesthesia, AOS [+] AOS [-]: cardiovascular [56.4%] [7.5%], respiratory [17.6%] . [3.5%], stroke [0.7%] [0.0% ], prolonged awakening from anaesthesia [2.5%] . [0.0%], postoperative fever [1.4%] [0.3%], difficult orotracheal intubation [3.5%] [0.3% ], unscheduled transfer to the intensive care unit [5.7%] [0.0%].
OSA [+] patients who underwent abdominal surgery under general anaesthesia had a higher rate of complications compared to OSA [-] patients, and also compared to patients who had undergone peripheral limb surgery. Surgery on the musculoskeletal system is much better tolerated by patients with OSA, suffering a lower number and range of events and postoperative complications. Loco-regional anaesthesia should be considered a priority in patients with OSA.
阻塞性睡眠呼吸暂停(OSA)患者术后并发症风险较高。本研究的目的是在一大群患者中,根据手术类型和麻醉类型,记录有无OSA患者术后并发症的范围和发生率。
我们进行了一项前瞻性描述性研究(n = 400)。获得了伦理委员会的批准并签署了书面知情同意书。使用柏林筛查问卷进行OSA筛查(77.2% - OSA[+])。术后记录不良事件和并发症(AOS[+]与AOS[-])。统计学方法:卡方检验。
在全身麻醉下进行腹腔手术的患者中并发症发生率最高,AOS[+]与AOS[-]:心血管并发症[56.4%]与[7.5%],呼吸并发症[17.6%]与[3.5%],中风[0.7%]与[0.0%],麻醉后苏醒延迟[2.5%]与[0.0%],术后发热[1.4%]与[0.3%],困难气管插管[3.5%]与[0.3%],非计划转入重症监护病房[5.7%]与[0.0%]。
与OSA[-]患者相比,以及与接受外周肢体手术的患者相比,全身麻醉下接受腹部手术的OSA[+]患者并发症发生率更高。OSA患者对肌肉骨骼系统手术的耐受性要好得多,发生的事件和术后并发症的数量和范围都较低。对于OSA患者,应优先考虑局部区域麻醉。