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根据STOP-BANG问卷评估口腔外科门诊麻醉患者群体中阻塞性睡眠呼吸暂停风险的患病率。

Prevalence of Obstructive Sleep Apnea Risk According to the STOP-BANG Questionnaire in an Oral Surgery Office-Based Anesthesia Patient Population.

作者信息

Goldberg Jason M, Silver Maxwell I, Johnson Michael P

机构信息

Resident, Oral and Maxillofacial Surgery, Yale New Haven Hospital, New Haven, CT.

DDS Candidate, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Oral Maxillofac Surg. 2020 Dec;78(12):2156-2159. doi: 10.1016/j.joms.2020.07.016. Epub 2020 Jul 18.

Abstract

PURPOSE

Patients with obstructive sleep apnea (OSA) are at an increased risk for perioperative and postoperative complications after receiving intravenous (IV) sedation or postoperative analgesia. We previously showed that most oral and maxillofacial surgery (OMS) providers do not screen for OSA using a quantifiable method. The purpose of this study was to determine the prevalence of OSA risk in the OMS office-based anesthesia patient population using the snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and gender (STOP-BANG) questionnaire.

PATIENTS AND METHODS

After deeming patients (n = 153) suitable for outpatient IV sedation using our existing institutional ambulatory preanesthesia protocol, 2 OMS providers administered the STOP-BANG questionnaire to classify patient risk for OSA. The questionnaire is a concise, validated predictor for OSA risk and consists of 8 yes or no questions.

RESULTS

Of the 153 patients, 141 (92.16%) were at a low risk for moderate to severe OSA, 11 (7.19%) were at a moderate risk, and 1 (0.65%) was at a high risk. Overall, 12 (7.84%) patients were shown to be at risk for OSA. We estimate with 95% confidence that between 5.7 and 10% of all OMS office-based anesthesia patients are at risk for OSA. The IV sedation plans for 4 (2.61%) patients were changed after including OSA risk with the existing preanesthesia protocol.

CONCLUSIONS

A statistically significant proportion (95% confidence interval, 0.0567 to 0.100) of the OMS office-based anesthesia patient population is at an increased risk for moderate to severe OSA. These results outline the importance of screening for OSA before office-based anesthesia administration. OMS providers can easily use the STOP-BANG questionnaire to assess OSA risk, modify anesthesia management, and improve patient safety.

摘要

目的

阻塞性睡眠呼吸暂停(OSA)患者在接受静脉(IV)镇静或术后镇痛后,围手术期和术后并发症的风险会增加。我们之前表明,大多数口腔颌面外科(OMS)医护人员未使用可量化方法筛查OSA。本研究的目的是使用打鼾、疲倦、观察到的呼吸暂停、高血压、体重指数、年龄、颈围和性别(STOP-BANG)问卷,确定在接受OMS门诊麻醉的患者人群中OSA风险的患病率。

患者与方法

在根据我们现有的机构门诊麻醉前方案确定患者(n = 153)适合门诊静脉镇静后,2名OMS医护人员使用STOP-BANG问卷对患者的OSA风险进行分类。该问卷是一种简洁、经过验证的OSA风险预测工具,由8个是或否的问题组成。

结果

在153例患者中,141例(92.16%)发生中度至重度OSA的风险较低,11例(7.19%)为中度风险,1例(0.65%)为高风险。总体而言,12例(7.84%)患者被证明有OSA风险。我们有95%的把握估计,所有接受OMS门诊麻醉的患者中有5.7%至10%有OSA风险。在将OSA风险纳入现有的麻醉前方案后,4例(2.61%)患者的静脉镇静计划发生了改变。

结论

在接受OMS门诊麻醉的患者人群中,有统计学意义的比例(95%置信区间,0.0567至0.100)发生中度至重度OSA的风险增加。这些结果概述了在门诊麻醉给药前筛查OSA的重要性。OMS医护人员可以轻松使用STOP-BANG问卷评估OSA风险、修改麻醉管理并提高患者安全性。

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