Quote from japaho41
With a growing (meaning heavier) patient population which then leads to more patients with OSA. It is always a concern of mine once the patient is in the PACU that they will obstruct their airway or be over nacrcotized. I make sure that I extubate these patient when they are alittle more awake than patient without OSA, taking a good tidal volume and adequate RR. Sit them up, unless contraindicated, use a nasal or oral airway if needed. Ideally the patient with OSA should bring there machine with them to the hospital the day of surgery and have it available to use in the PACU. Most patients are not told to do so and think because they are in the hospital that there will be one available for them to use. I guess that all goes back to there pre-op instructions.
I like it when the patients bring their cpap with them and I like when they airways in place.
Is it feasible to have airways in during surgery for the non-general anesthesia patients? Seems like an oral airway would be a great idea. It could just be left in as long as needed, couldn't it?
Do you have plans at your facility to start telling OSA pts to bring their CPAP machines? The patients probably don't give it any thought. They probably think that someone would instruct them on everything to do , not do, what to bring or not bring, etc., especially something as vital as their CPAP machines. It is simple enough to tell them to bring it. But I think a lot of facilities don't, incredibly, think of OSA when they are dealing with pre-op patients. That is why we have a special unit, as mentioned. I'm glad you brought this up.
What percentage of OSA patients have a problem in your experience, either in OR or RR? Does someone from Anesthesia stay immediately at hand post-op for an hour or more? Anything else you can think of re: OSA and surgery/recovery?