Oh Matthew W, Chen Joy L, Moon Tiffany S
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, United States.
Saudi J Anaesth. 2022 Jul-Sep;16(3):299-305. doi: 10.4103/sja.sja_300_22. Epub 2022 Jun 20.
The prevalence of patients with obesity continues to rise worldwide and has reached epidemic proportions. There is a strong correlation between obesity and sleep-disordered breathing (SDB), and, in particular, obstructive sleep apnea (OSA). OSA is often undiagnosed in the surgical population. Bariatric surgery has been recognized as an effective treatment option for both obesity and OSA. Laparoscopic bariatric procedures, particularly laparoscopic sleeve gastrectomy (LSG), have become the most frequently performed procedures. OSA has been identified as an independent risk factor for perioperative complications and failure to recognize and prepare for patients with OSA is a major cause of postoperative adverse events, suggesting that all patients undergoing bariatric surgery should be screened preoperatively for OSA. These patients should be treated with an opioid-sparing analgesic plan and continuous positive airway pressure (CPAP) perioperatively to minimize respiratory complications. With the number of bariatric surgical patients with SDB likely to continue rising, it is critical to understand the best practices to manage this patient population.
全球肥胖患者的患病率持续上升，已达到流行程度。肥胖与睡眠呼吸紊乱（SDB），尤其是阻塞性睡眠呼吸暂停（OSA）之间存在密切关联。OSA在外科手术人群中常常未被诊断出来。减肥手术已被公认为治疗肥胖症和OSA的有效选择。腹腔镜减肥手术，特别是腹腔镜袖状胃切除术（LSG），已成为最常施行的手术。OSA已被确定为围手术期并发症的独立危险因素，未能识别和为OSA患者做好准备是术后不良事件的主要原因，这表明所有接受减肥手术的患者术前都应接受OSA筛查。这些患者围手术期应采用减少阿片类药物的镇痛方案和持续气道正压通气（CPAP）治疗，以尽量减少呼吸并发症。随着患有SDB的减肥手术患者数量可能继续增加，了解管理这一患者群体的最佳实践至关重要。
