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Revista americana de medicina respiratoria
versión On-line ISSN 1852-236X
Resumen
BARIMBOIM, Enrique. Apnea del sueño como factor de riesgo en intervenciones quirúrgicas. Rev. am. med. respir. [online]. 2014, vol.14, n.3, pp.272-279. ISSN 1852-236X.
The prevalence of obstructive sleep apnea (SAHS) in the general population ranges from 2 to 6% by age group and gender. Few patients with confirmed diagnosis and fewer are treated. In the course of life must be subjected to different types of surgeries. The increased surgical risk has been demonstrated in several studies. A meta-analysis confirmed the increased complications (postoperative desaturation, acute respiratory failure, cardiac events and the need for transfer to ICU) in this population. The rise of bariatric surgery for morbidly obese patients, who also have a high incidence of SAHS is further underlined. Multiple pathophysiological mechanisms involved before and after surgery, the influence of the type of surgery, the effects of sedative drugs, anesthetics and analgesics on respiratory function are reviewed. Proper preoperative evaluation is recommended. Validated questionnaires, Berlin, STOP-BANG, P-SAP can help in this task, along with clinical judgment. Postoperative time is the most critical and requires greater controls. It seems prudent and rational use of CPAP equipment for patients who previously used in the home. Not fully validated this recommendation for patients who are not suitable. Its use could reduce related complications.
Palabras clave : Obstructive sleep apnea; Surgery; Postoperative complications; Preoperative assessment.