ANAESTHETICS & SURGEONS

Even in USA , 85% of OSA Cases are undiagnosed. In India, the undiagnosed cases could be even higher. This will be true even for patients coming in for surgery.

Since moderate to severe OSA has been associated with high incidence of morbidity and mortality, ascertaining the presence of OSA should form part of pre surgery investigation. Post surgery periods are very vulnerable considering the fact that the patient may be on sedation and or are on opioids .Add to the trouble is absence of Anesthetists. STOP BANG test should form part of pre surgery investigation followed by sleep tests. Since full sleep lab tests are expensive and time consuming, experts have recommended Home sleep tests as the best alternative.

With post-operative mortality in patients with OSA

“OSA has been associated with an increase in post-operative complications and is an independent risk factor for increased morbidity and mortality”.
[International Anesthesia Research Society 2010]
“Assess the existence/severity of OSA pre procedure to ensure that patient selection is appropriate for the type of procedure and anesthesia planned”
[AAHC Institute for Quality Improvement -Patient safety tool kit]

Sleep test mandatory before Bariatric surgery

“It has been suggested that OSA screening by polysomnography should be mandatory for all patients undergoing bariatric surgery”
[Current Opinion in Anesthesiology 2009]

Only sleep tests can confirm OSA

“OSA can be diagnosed definitively only by polysomnography”. OSA affects every aspect of Anesthesia delivery”
[AANA journal 2009]

Home sleep is recommended for pre-surgery evaluation

“If OSA is suspected, a comprehensive sleep evaluation must be conducted “In addition to proper screening measures, pre-operative preparation can include the use of home sleep tests as a diagnostic tool for OSA”
[Perioperative management of OSA, UC SANDEIGO SCHOOL OF MEDICINE – Monograph]