Turkish Anaesthesiologist's Experiences of Anaesthetic Management of Patients with Obstructive Sleep Apnea (OSA)

Perioperative care of obstructive sleep apnea patients: A survey of European anesthesiologists

Background:

Obstructive sleep apnea (OSA) is prevalent in the surgical patient population and is associated with high risk of perioperative complications. There are limited guidelines and wide practice variations regarding the perioperative care of obese and OSA patients. This is a study of European anesthesiologists' clinical practice of perioperative care of OSA patients.

Methods:

This survey evaluated United Kingdom anesthesiologists' clinical practice of the perioperative care of OSA patients. Outcomes and variables were compared between 4100 anesthesiologists of different clinical experience and hospital settings.

Results:

Approximately 45% of respondents manage OSA patients rarely, 42% occasionally, and 13% regularly. Most respondents order OSA screening tests if patients have tonsillar hypertrophy, head/neck tumor, BMI >35, increased neck circumference, craniofacial anomaly, and right-sided electrocardiography (ECG) anomaly. Majority request preoperative polysomnography, ECG, overnight pulse oximetry, and arterial blood gas analysis. Majority recommend preoperative weight loss, optimisation, smoking cessation, reduction of substance use, and regular mask-CPAP use. Majority consider endoscopy, and ophthalmology as appropriate day case procedures, but not laparoscopy. Majority postpone elective airway, laparoscopic, laparotomy, and head/neck surgery; if patients are not optimized preoperatively. For major surgery, combined general + neuraxial anesthesia was ranked as 3^rd option. For major limb surgery, neuraxial anesthesia without sedation was ranked as 1^st option, nerve block without sedation was ranked 2^nd, and general anesthesia + nerve block was ranked 3^rd or 4^th. At anesthesia emergence, majority ensure that patients have normal consciousness, respiration and neuromuscular function. Majority ensure postoperative oximetry, telemetry, and oxygen supplementation.

Conclusion:

This study highlights variations in anesthesiologists' perioperative care of OSA patients; even in developed countries with advanced medical training and standards. The study outcomes will improve perioperative care of OSA patients.

Knowledge, attitude, and clinical practice of dentists toward obstructive sleep apnea: A literature review

OBJECTIVE

To review the knowledge, attitude, and clinical practice of dentists and dental specialists toward obstructive sleep apnea (OSA).

METHODS

A literature search was performed on PubMed and ScienceDirect databases. Peer-reviewed English publications were reviewed. No time limit was applied.

RESULTS

Four articles were included for the review. Years in the profession, specialist training, and gender were associated with the level of knowledge about OSA. Weight control was the most recognizable treatment for patients with OSA. Dentists agreed that OSA is a life-threatening disease, and they could be involved in detecting and treating OSA. Most dentists had no clinical experience of managing patients with OSA.

CONCLUSION

Dentists had a certain level of knowledge about OSA and were willing to deal with OSA. However, they lacked clinical experience. They were also enthusiastic about further education on OSA.

Obstructive sleep apnoea and its knowledge and attitude among Indian anaesthesiolgists - A survey study

BACKGROUND AND AIMS

Obstructive sleep apnoea (OSA) has an estimated prevalence of 2%-4% in adult population and is increasing. Most of these are detected late which is the cause for higher perioperative morbidity. This survey was aimed to seek the level of knowledge and attitude of Indian anaesthesiologists towards OSA.

METHODS

The OSA Knowledge and Attitude (OSAKA) questionnaire (23-statements) was distributed to the anaesthesiologists attending the difficult airway conference in December 2017. The first section has 18 statements pertaining to OSA knowledge. The second section consists of five statements to evaluate self-confidence in the management of OSA. Age, gender, professional title, type of hospital, years of experience, and bariatric experience were analysed.

RESULTS

205 out of 350 participants responded. In all, 201 (57.4%) fully completed responses were analysed. The mean ± standard deviation knowledge and attitude scores were 12.01 ± 2.88 (66.72% ± 16%) and 18.16 ± 3.75 (72.64% ± 15%) respectively. On exclusion of junior residents (n = 56), knowledge and attitude scores of qualified anaesthesiologists were 12.7 ± 2.55 (70.55% ± 14.16%) and 18.78 ± 3.91 (75.12% ± 15.64%), respectively. Anaesthesiologists with bariatric experience had a significantly higher attitude score when compared with those who do not practice bariatric surgeries (P < 0.01). There is weak but significant, positive linear correlation between knowledge and attitude score (r_s= 0.370, P < 0.01).

CONCLUSION

Deficit of adequate knowledge about OSA exists among Indian anaesthesiologists. Experience of managing cases with OSA seems to improve knowledge and attitude towards OSA.