2025, Vol. 8, Issue 2, Part B
Perioperative anesthetic management of obstructive sleep apnea: Strategies for safety and risk reduction: A review
Author(s): Ardalan Papari
Abstract: Obstructive Sleep Apnea (OSA) poses significant challenges in anesthesia due to airway obstruction, respiratory depression, and altered drug sensitivity. Patients with OSA are at a higher risk of difficult airway management, rapid oxygen desaturation, and postoperative respiratory complications. Anesthetic agents, including sedatives, opioids, and neuromuscular blockers, can exacerbate airway collapsibility and respiratory suppression. Regional anesthesia is preferred when feasible, as it reduces systemic anesthetic requirements and avoids airway manipulation. Careful selection and titration of anesthetic and analgesic medications, including opioid-sparing multimodal pain management strategies, are essential to minimize respiratory depression.
Postoperative monitoring, including continuous pulse oximetry and capnography, is crucial to detect early signs of respiratory compromise. The use of Positive Airway Pressure (PAP) therapy before and after surgery may improve oxygenation and reduce complications, although compliance remains a challenge. Positional strategies, such as lateral or semi-upright positioning, can help maintain airway patency. Supplemental oxygen should be administered with caution to avoid worsening hypoventilation and hypercapnia. Despite current safety recommendations, the implementation of OSA-specific perioperative interventions remains inconsistent, and improved screening tools and monitoring protocols are needed.
This review article explores the impact of anesthesia on OSA patients, highlighting challenges in airway management, medication selection, postoperative monitoring, and perioperative strategies to enhance patient safety. It also discusses current recommendations and the need for further research to refine risk stratification and optimize perioperative care for this high-risk population.
DOI: 10.33545/26643766.2025.v8.i2b.566
Pages: 109-113 | Views: 156 | Downloads: 55
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How to cite this article:
Ardalan Papari. Perioperative anesthetic management of obstructive sleep apnea: Strategies for safety and risk reduction: A review. Int J Med Anesthesiology 2025;8(2):109-113. DOI: 10.33545/26643766.2025.v8.i2b.566
