Abstract
The purpose of the Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea (OSA) is to present recommendations based on current scientific evidence. This guideline seeks to address questions regarding the intraoperative care of patients with OSA, including airway management, anesthetic drug and agent effects, and choice of anesthesia type. Given the paucity of high-quality studies with regard to study design and execution in this perioperative field, recommendations were to a large part developed by subject-matter experts through consensus processes, taking into account the current scientific knowledge base and quality of evidence. This guideline may not be suitable for all clinical settings and patients and is not intended to define standards of care or absolute requirements for patient care; thus, assessment of appropriateness should be made on an individualized basis. Adherence to this guideline cannot guarantee successful outcomes, but recommendations should rather aid health care professionals and institutions to formulate plans and develop protocols for the improvement of the perioperative care of patients with OSA, considering patient-related factors, interventions, and resource availability. Given the groundwork of a comprehensive systematic literature review, these recommendations reflect the current state of knowledge and its interpretation by a group of experts at the time of publication. While periodic reevaluations of literature are needed, novel scientific evidence between updates should be taken into account. Deviations in practice from the guideline may be justifiable and should not be interpreted as a basis for claims of negligence.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 967-987 |
| Number of pages | 21 |
| Journal | Anesthesia and analgesia |
| Volume | 127 |
| Issue number | 4 |
| DOIs | |
| State | Published - 2018 |
Funding
Conflicts of Interest: None. Name: Lukas Pichler, MD. Contribution: This author helped analyze the data and write the manuscript. Conflicts of Interest: None. Name: Satya Krishna Ramachandran, MD. Contribution: This author helped conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: S. K. Ramachandran funded research from Merck, Sharp & Dohme, New Jersey. Name: Frances Chung, MBBS, FRCPC. Contribution: This author helped design the study, conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: F. Chung received research grants from Ontario Ministry of Health and Long-Term Care Innovation Fund, University Health Network Foundation, ResMed Foundation, Acacia Pharma, and Medtronics Inc STOP-Bang tool: proprietary to University Health Network, royalties from Up-To-Date. This manuscript was handled by: David Hillman, MD. Name: Stavros G. Memtsoudis, MD, PhD. Contribution: This author helped design the study, conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: S. G. Memtsoudis is a director on the boards of the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the Society of Anesthesia and Sleep Medicine (SASM). He is a 1-time consultant for Sandoz Inc and the holder of US Patent Multicatheter Infusion System US-2017-0361063. He is the owner of SGM Consulting, LLC, and co-owner of FC Monmouth, LLC. None of these relations influenced the conduct of the present study. Name: Crispiana Cozowicz, MD. Contribution: This author helped design the study, conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: None. Name: Mahesh Nagappa, MD. Contribution: This author helped conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: None. Name: Jean Wong, MD, FRCPC. Contribution: This author helped conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: J. Wong has received research grants from Acacia Pharma. Name: Girish P. Joshi, MBBS, MD, FFARCSI. Contribution: This author helped conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: G. P. Joshi received an honorarium from Baxter Pharmaceuticals, Mallinckrodt Pharmaceuticals, Merck Pharmaceuticals, and Pacira Pharmaceuticals. Name: David T. Wong, MD, FRCPC. Contribution: This author helped conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: None. Name: Anthony G. Doufas, MD, PhD. Contribution: This author helped conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: None. Name: Meltem Yilmaz, MD. Contribution: This author helped conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: M. Yilmaz serves on the advisory board of VitaHEAT Medical. Name: Mark H. Stein, MD. Contribution: This author helped conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: None. Name: Megan L. Krajewski, MD. Contribution: This author helped conduct the study, analyze the data, and write the manuscript. Conflicts of Interest: None. Name: Mandeep Singh, MBBS, MD, MSc, FRCPC. Contribution: This author helped conduct the study, analyze the data, and write the manuscript.
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine