Polysomnography after adenotonsillectomy in mild pediatric obstructive sleep apnea
| Autor: | David G. Nichols, Susanna A. McColley, David E. Tunkel, Max M. April, Mark A. Helfaer, Lynne G. Maxwell, Fuad M. Baroody, Gerald M. Loughlin, Paula L. Pyzik |
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| Rok vydání: | 1996 |
| Předmět: |
medicine.medical_specialty
Adolescent Polysomnography medicine.medical_treatment Intensive Care Units Pediatric Critical Care and Intensive Care Medicine Adenoidectomy Postoperative Complications Sleep Apnea Syndromes Humans Medicine Anesthesia Prospective Studies Child Intensive care medicine Tonsillectomy Pediatric intensive care unit medicine.diagnostic_test business.industry Infant medicine.disease Sleep in non-human animals respiratory tract diseases Obstructive sleep apnea El Niño Child Preschool Emergency medicine business |
| Zdroj: | Critical Care Medicine. 24:1323-1327 |
| ISSN: | 0090-3493 |
| Popis: | a) To determine the need for intensive monitoring on the first operative night of surgery in children undergoing adenotonsillectomy for mild obstructive sleep apnea; b) to examine the effect of narcotics on postoperative obstructive sleep apnea.Randomized, prospective study.University hospital.Children, ranging in age between 1 and 18 yrs, presented to the Pediatric Otolaryngology Clinic for adenotonsillectomy for mild obstructive sleep apnea defined as from one to 15 obstructive apnea events per hour on preoperative polysomnogram.Patients were assigned to receive either a narcotic- or a halothane-based anesthetic for adenotonsillectomy. A postoperative polysomnogram was performed in the pediatric intensive care unit on the first operative night.Eighteen patients were recruited, 15 of whom met inclusion criteria: nine patients received a halothane-based anesthetic and six patients received a fentanyl-based anesthetic. When the data were analyzed by pooling both groups, the differences between pre- and postoperative sleep studies demonstrated a reduction in the number of obstructive events and less severe oxygen desaturations on the operative night. Total sleep time between the two sleep studies decreased from 371 +/- 13 to 304 +/- 14 mins. The number of obstructive apnea events/hr decreased as well. The lowest oxygen saturation measured during rapid eye movement sleep was 78 +/- 5% preoperatively and 92 +/- 1% postoperatively.Our data suggest that children without underlying medical conditions, neuromotor diseases, or carniofacial abnormalities, 1 to 18 yrs of age, who suffer from mild obstructive sleep apnea, have improvements documented by polysomnography on the night of surgery following adenotonsillectomy and do not necessarily need to be monitored intensively. These findings were not significantly affected by the choice of intraoperative anesthetic. |
| Databáze: | OpenAIRE |
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