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我们是否应该采取预防措施,避免在经蝶窦手术后延迟 CPAP 恢复时出现呼吸功能障碍?一位严重阻塞性睡眠呼吸暂停患者的另一种处理方法:病例报告。

Should we take precautions to avoid respiratory compromise while delaying CPAP resumption following transsfenoidal surgery? An alternative approach in a patient with severe obstructive sleep apnea: case report.

机构信息

Anesthesiology, LIV Hospital Vadistanbul, Istanbul, Turkey.

Anesthesiology and Reanimation, Istinye University, Istanbul, Turkey.

出版信息

Acta Neurochir (Wien). 2022 Jun;164(6):1615-1618. doi: 10.1007/s00701-022-05213-x. Epub 2022 Apr 28.

Abstract

BACKGROUND

We describe a patient with severe obstructive sleep apnea scheduled for transsfenoidal surgery. Early postoperative use of continuous positive airway pressure (CPAP) was considered unsafe because increased risk of intracranial complications.

METHODS

Aiming to bypass the upper airway obstruction and thus avoid CPAP, a 6-mm nasopharyngeal airway was introduced by the surgical team under endoscopic vision. In the postoperative period and during follow-up, patient and his family did not complain about apnea/hypopnea episodes and nasopharyngeal airway was tolerated comfortably.

CONCLUSION

We recommend this technique as an alternative in obstructive sleep apnea patients undergoing transsfenoidal surgery.

摘要

背景

我们描述了一位患有严重阻塞性睡眠呼吸暂停症的患者,该患者计划接受经蝶窦手术。由于颅内并发症风险增加,术后早期使用持续气道正压通气(CPAP)被认为是不安全的。

方法

为了绕过上呼吸道阻塞,从而避免 CPAP,手术团队在内镜下引入了一个 6 毫米的鼻咽气道。在术后期间和随访期间,患者及其家属没有抱怨呼吸暂停/低通气事件,并且舒适地耐受了鼻咽气道。

结论

我们建议将这种技术作为经蝶窦手术的阻塞性睡眠呼吸暂停患者的替代方法。

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