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. 2012 Apr 15;8(2):199–207. doi: 10.5664/jcsm.1784

Table 3.

Perioperative management of patients at high risk of obstructive sleep apnea syndrome

Preoperative Evaluation

  1. History

  2. Physical Examination

  3. Screening Questionnaires like Berlin, ASA, or STOP BANG to identify high-risk patients

  4. Consider a formal sleep evaluation in very high-risk group

Intraoperative Management

  1. Minimize the surgical stress

  2. Reduce the duration of surgery

  3. Consider regional or local anesthesia instead of general anesthesia

  4. Anticipate difficult intubation

  5. Consider awake extubation preferably in semi-upright position

Postoperative Management

  1. Minimize the use of opioids and sedation after the surgery

  2. Consider using acetaminophen, NSAIDs, or regional analgesia for the pain control

  3. Continuously monitor oxygenation in the postoperative period

  4. Patients with a known diagnosis of sleep apnea should use their CPAP after the surgery

  5. High-risk patients for sleep apnea should use Auto CPAP during the postoperative period

  6. Follow-up at the sleep center for the management of sleep apnea upon discharge from the hospital