Journal of Anesthesia

, Volume 27, Issue 3, pp 423–432

Postoperative apnea, respiratory strategies, and pathogenesis mechanisms: a review

  • Alan D. Kaye
  • McKenzie Mayo Hollon
  • Nalini Vadivelu
  • Gopal Kodumudi
  • Rachel J. Kaye
  • Franklin Rivera Bueno
  • Amir R. Baluch
Review Article

DOI: 10.1007/s00540-012-1517-0

Cite this article as:
Kaye, A.D., Hollon, M.M., Vadivelu, N. et al. J Anesth (2013) 27: 423. doi:10.1007/s00540-012-1517-0

Abstract

Recovery from anesthesia is ideally routine and uneventful. After extubation, the recovering postoperative patient ought to breathe without supportive care or additional oxygenation. It has been demonstrated in previous studies that postoperative pulmonary complications are clinically relevant in terms of mortality, morbidity, and length of hospital stay. Compromised postoperative ventilation can be described as the condition in which the postoperative patient does not have satisfactory spontaneous ventilation support and adequate oxygenation. Causes of impaired ventilation, oxygenation, and airway maintenance can be mechanical, hemodynamic, and pharmacologic. This review describes prevalence and differential diagnosis, including co-morbidities of postoperative apnea. The physiological mechanisms of breathing and prolonged postoperative apnea are also reviewed; these mechanisms include influences from the brainstem, the cerebral cortex, and chemoreceptors in the carotid and aortic body. Causes of prolonged postoperative apnea and management are also discussed.

Keywords

Postop apneaObesityMedicationsBrain mechanisms

Copyright information

© Japanese Society of Anesthesiologists 2012

Authors and Affiliations

  • Alan D. Kaye
    • 1
    • 6
  • McKenzie Mayo Hollon
    • 2
  • Nalini Vadivelu
    • 3
  • Gopal Kodumudi
    • 4
  • Rachel J. Kaye
    • 1
  • Franklin Rivera Bueno
    • 1
  • Amir R. Baluch
    • 5
  1. 1.Department of AnesthesiologyLouisiana State University School of Medicine, Louisiana State University Health Science CenterNew OrleansUSA
  2. 2.Department of AnesthesiologyEmory UniversityAtlantaUSA
  3. 3.Yale University School of MedicineNew HavenUSA
  4. 4.School of Liberal Arts and SciencesUniversity of ConnecticutStorrsUSA
  5. 5.Metropolitan Anesthesia ConsultantsDallasUSA
  6. 6.Department of PharmacologyLouisiana State University Health Science CenterNew OrleansUSA