Perioperative risk stratification for a patient with severe obstructive sleep apnoea undergoing laparoscopic banding surgery.
نویسندگان
چکیده
Despite the increasing prevalence of obstructive sleep apnoea (OSA), there is limited evidence to guide appropriate preoperative investigations, inpatient or outpatient surgery allocation, and the anticipated level of postoperative care. With reference to our institution's perioperative risk stratification, we describe the case of a 46-year-old Caucasian male with a body mass index of 51 kg/m(2) admitted for laparoscopic band insertion. Management based on our guidelines involved a preoperative polysomnography where the patient was confirmed to have severe OSA. His postoperative care was then managed in the high dependency care unit. He was discharged home on day 2 with no further sequelae. We provide evidence that adoption of this model of care can simplify clinical decision making and resource allocation with favourable patient outcomes.
منابع مشابه
Obstructive sleep apnoea and perioperative complications in bariatric patients.
BACKGROUND The objective of this study was to determine the relationship between perioperative complications and the severity of obstructive sleep apnoea (OSA) in patients undergoing bariatric surgery who had undergone preoperative polysomnography (PSG). METHODS The records of 797 patients, age >18 yr, who underwent bariatric operations (442 open and 355 laparoscopic procedures) at Mayo Clini...
متن کاملObstructive sleep apnoea (OSA) patterns in bariatric surgical practice and response of OSA to weight loss after laparoscopic adjustable gastric banding (LAGB).
INTRODUCTION This study aims to evaluate the incidence of Obstructive Sleep Apnoea (OSA) in severely obese Asians and to study the impact of weight loss on OSA. MATERIALS AND METHODS We report the results of routine preoperative Polysomnograms in 350 Asian patients undergoing bariatric surgery in our institute. Polysomnograms were repeated in 75 randomly selected patients with moderate to sev...
متن کاملPerioperative risk factors in obese patients for bariatric surgery: a Singapore experience.
INTRODUCTION Morbid obesity and obstructive sleep apnoea (OSA) are increasingly encountered in anaesthetic practice today. Difficult intubation may be seen more frequently in our practice. This high-risk group may also be more prone to complications in the postoperative period. METHODS We reviewed a consecutive series of patients who had undergone laparoscopic gastric banding at our instituti...
متن کاملRisk stratification for obstructive sleep apnoea and optimal post-operative monitoring in an overnight stay ward
Objectives Prospective data is required to clarify the role of a one night stay ward (23‐hour ward, 23HW) for the post‐operative monitoring of surgical patients with obstructive sleep apnoea (OSA). The aim was to use a modified American Society of Anesthesiologists (ASA) screening tool to stratify the perioperative risk of OSA related complications and evaluate the role of a 23HW in the post‐op...
متن کاملPerioperative Factors Affecting Ambulatory Outcomes Following Laparoscopic-Adjustable Gastric Banding.
Objective Morbidly obese patients are traditionally hospitalised following bariatric surgery. However, laparoscopic-adjustable gastric banding (LAGB) is amenable for ambulatory care. We hypothesised that the majority of patients can receive an ambulatory LAGB and that both surgical and anaesthetic perioperative factors will significantly affect non-ambulatory LAGB outcomes. Methods Medical re...
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عنوان ژورنال:
- BMJ case reports
دوره 2013 شماره
صفحات -
تاریخ انتشار 2013