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Anesthesia Management in OSA Patient

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The Role of Epiglottis in Obstructive Sleep Apnea

Abstract

Obstructive sleep apnea (OSA) is a complex disease characterized by partial or complete obstructions of the upper respiratory tract and oxygen desaturations during sleep. Acute and chronic pathologies of the epiglottis that cause OSA, despite being uncommon, mandate attention from both anesthetist and surgeon, as they impose certain challenges to both diagnosis and management. Preoperative evaluation is a powerful tool that defines the safe practice of anesthesia from unsafe, especially in patients with OSA. A proper preoperative assessment should ensure sufficient time for any possible optimization of the patient’s condition to decrease his/her perioperative risk. The administration of sedatives, anesthetics, and analgesics in OSA patients worsen obstructions of the pharynx. Evaluation and planning of airway management during preoperative assessment, with a strategy that includes multiple exit routes if needed, ensures a safe airway management with minimum unnecessary risks. Patients with OSA have a higher probability for desaturations, respiratory complications, and cardiac events in the postoperative period. OSA patients are more prone to upper airway collapse in the postoperative period and this is due to multiple factors including anesthetic agents’ effect, use of sedative or opioids medications, weak pharyngeal muscle tone, and weak reawaking response to hypoxia in these patients. The focus of this chapter is on perioperative management of OSA patients, with special attention to OSA caused by the epiglottis.

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Authors and Affiliations

  1. Department of Anaesthesia, ICU and Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar

    Abdulrahman Dardeer, Muhammad Firas Alhammad & Nabil A. Shallik

  2. Department of Clinical Anesthesiology, Weill Cornell Medical College in Qatar, Al Rayyan, Qatar

    Nabil A. Shallik

  3. Department of Clinical Anesthesiology, Qatar University, Doha, Qatar

    Nabil A. Shallik

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  2. Muhammad Firas Alhammad
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  3. Nabil A. Shallik
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Correspondence to Nabil A. Shallik .

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  1. General Hospital Celje, Celje, Slovenia

    Matej Delakorda

  2. Jan Tooropstraat, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands

    Nico de Vries

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Dardeer, A., Alhammad, M.F., Shallik, N.A. (2023). Anesthesia Management in OSA Patient. In: Delakorda, M., de Vries, N. (eds) The Role of Epiglottis in Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-031-34992-8_26

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