Preoperative Preparation 

 

  • Preoperative initiation of CPAP should be considered, particularly if OSA is severe. For patients who do not respond adequately to CPAP, NIPPV should be considered. In addition, the preoperative use of mandibular advancement devices or oral appliances & preoperative weight loss should be considered. 

  • A patient who has had corrective airway surgery (e.g., uvulopalatopharyngoplasty, surgical mandibular advancement) should be assumed to remain at risk of OSA complications unless a normal sleep study has been obtained & symptoms have not returned. 

  • Remember potentially difficult airway  

  • Things to examine: 

    • Evaluation of the airway

    • Nasopharyngeal characteristics

    • Neck circumference

    • Tonsil size

    • Tongue volume

 

 

Adapted from:

  • American Society of Anesthesia Guidelines 2014:  Anesthesiology. 2014 Feb;120(2):268-86.

  • The Canadian Anesthesia Society Guidelines 2010:  Can J Anaesth. 2010 Sep;57(9):849-64

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