Postoperative respiratory complications after adenotonsillectomy in children with obstructive sleep apnea

2021 ◽  
pp. 110835
Author(s):  
Alfonso Caetta ◽  
Alisa Timashpolsky ◽  
Stephanie M. Tominaga ◽  
Neeta D'Souza ◽  
Nira A. Goldstein
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Respiratory Complications ◽  
Obstructive Sleep ◽  
Postoperative Respiratory Complications

Urgent Adenotonsillectomy

2003 ◽  
Vol 99 (3) ◽  
pp. 586-595 ◽  
Author(s):  
Karen A. Brown ◽  
Isabelle Morin ◽  
Chantal Hickey ◽  
John J. Manoukian ◽  
Gillian M. Nixon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Medical Intervention ◽  
Control Group ◽  
Respiratory Complications ◽  
Obstructive Sleep ◽  
Postoperative Respiratory Complications

Background The aim of this study was to determine the frequency and type of respiratory complications after urgent adenotonsillectomy (study group) for comparison with a control group of children undergoing a sleep study and adenotonsillectomy for obstructive sleep apnea syndrome. A second aim was to assess risk factors predictive of respiratory complications after urgent adenotonsillectomy. Methods The perioperative course of children who underwent adenotonsillectomy between January 1, 1999, and March 31, 2001, was reviewed. Two groups of children were identified from two different databases: the hospital database for surgical procedures (the study group) and the sleep laboratory database (the control group). The retrospective chart review focused on the preoperative status (including an evaluation for obstructive sleep apnea), anesthetic management, and need for postoperative respiratory interventions. Results A total of 64 consecutive cases for urgent adenotonsillectomy were identified, and 54 children met the inclusion criteria. Thirty-three children (60%) had postoperative respiratory complications necessitating a medical intervention; 11 (20.3%) required a major intervention (reintubation, ventilation, and/or administration of racemic epinephrine or Ventolin), and 22 (40.7%) required a minor intervention (oxygen administration). Six children (11.1%) required reintubation in the recovery room for respiratory compromise. Risk factors for respiratory complications were an associated medical condition (odds ratio, 8.15; 95% confidence interval, 1.81-36.73) and a preoperative saturation nadir less than 80% (odds ratio, 5.54; 95% confidence interval, 1.15-26.72). Sixteen (49%) of the medical interventions were required within the first postoperative hour. Atropine administration, at induction, decreased the risk of postoperative respiratory complications (odds ratio, 0.18; 95% confidence interval, 0.11-1.050. Control Group Of 75 children who underwent a sleep study and adenotonsillectomy, 44 had sleep apnea and were admitted to hospital after elective adenotonsillectomy. Sixteen (36.4%) children had postoperative respiratory complications necessitating a medical intervention. Six percent of the children (n = 3) required a major medical intervention. No child required reintubation for respiratory compromise. Conclusions Severe obstructive sleep apnea syndrome and an associated medical condition are risk factors for postadenotonsillectomy respiratory complications. Risk reductions strategies should focus on their assessment.

scholarly journals Respiratory Complications of Adenotonsillectomy for Obstructive Sleep Apnea in the Pediatric Population

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
G. Marrugo Pardo ◽  
L. F. Romero Moreno ◽  
P. Beltrán Erazo ◽  
C. Villalobos Aguirre
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pediatric Population ◽  
Early Postoperative Period ◽  
Respiratory Complication ◽  
Apnea Hypopnea Index ◽  
Respiratory Complications ◽  
Obstructive Sleep ◽  
Postoperative Respiratory Complications ◽  
Postanesthetic Care Unit

Objective. To determine the prevalence of respiratory complications in the early postoperative period of children with sleep apnea who required adenotonsillectomy at a tertiary pediatric hospital and to establish recommendations for postoperative monitoring. Methods. Retrospective cohort study of children with obstructive sleep apnea (OSA) diagnosed by polysomnogram (PSG), who underwent adenotonsillectomy for treatment of OSA. The prevalence of respiratory complications in the first 24 postoperative hours was measured. Patients with craniofacial malformations, obesity, and severe cardiovascular comorbidities were excluded. The prevalence of postoperative respiratory complications was compared with the severity of OSA according to the Apnea Hypopnea Index (AHI) and NADIR. All data were taken in patients residing in Bogotá city, Colombia, at 2.640 meters above sea level (m.a.s.l). Results. Between May 2014 and February 2017, 167 patients (108 males) required adenotonsillectomy for OSA, with an age range of 1 and 15 years (mean 5.3 years +/- 2.7). The prevalence of postoperative respiratory complications was 3.59% (6/167). There was a statistically significant relationship between the presence of respiratory complication and AHI greater than 44/h (p <0.04). There was an inverse correlation between the AHI and NADIR values. Risk groups of patients younger than 3 years and NADIR less than 70% had a higher prevalence of respiratory complications; however, this correlation was not statistically significant (p <0.08 and 0.89, respectively). Conclusions. The prevalence of respiratory complications in OSA patients undergoing adenotonsillectomy in high altitudes is similar to that reported in other heights. Preoperative AHI greater than 44/h could be considered a risk factor for early respiratory complication. We suggest ambulatory management after 6 hours in Postanesthetic Care Unit (PACU) observation in patients older than 3 years, with AHI less than 44/h and NADIR greater than 70% in altitudes higher than 2.500 m.a.s.l. Further research must be done to confirm this hypothesis.

scholarly journals Postoperative Respiratory Complications in Patients at Risk for Obstructive Sleep Apnea

2017 ◽  
Vol 125 (1) ◽  
pp. 272-279 ◽  
Author(s):  
Satya Krishna Ramachandran ◽  
Jaideep Pandit ◽  
Scott Devine ◽  
Aleda Thompson ◽  
Amy Shanks
Keyword(s):  
At Risk ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Respiratory Complications ◽  
Obstructive Sleep ◽  
Patients At Risk ◽  
Postoperative Respiratory Complications

Obstructive Sleep Apnea

2018 ◽  
Author(s):  
Laura Ryan ◽  
Paul Hopkins
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Postoperative Nausea And Vomiting ◽  
Respiratory Morbidity ◽  
Respiratory Complications ◽  
Parental History ◽  
Perioperative Analgesia ◽  
Obstructive Sleep ◽  
Postoperative Respiratory Complications ◽  
Overnight Polysomnography

Adenotonsillectomy is one of the most commonly performed surgeries in children and is the mainstay treatment for obstructive sleep apnea (OSA). Children with OSA have a higher risk of perioperative respiratory morbidity. Diagnosis of OSA is made by overnight polysomnography, but this resource is rare and expensive so children at risk for OSA must be identified based on parental history. Patients with risk factors for postoperative respiratory complications may need to be monitored in the hospital overnight. Anesthetic challenges associate with adenotonsillectomy include perioperative analgesia, prevention and treatment of postoperative nausea and vomiting, risk of airway fire, and management of airway obstruction.

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