Clinical Indicators of the Need for Telemetry Postoperative Monitoring in Patients With Suspected Obstructive Sleep Apnea Undergoing Total Knee Arthroplasty
| Autor: | Zhang Wei, Stavros G. Memtsoudis, Kethy M. Jules-Elysee, Natasha A. Desai, Gregory A. Liguori, Thuyvan H. Luu, Yan Ma |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Time Factors Knee Joint medicine.medical_treatment Sedation Polysomnography Administration Oral 030204 cardiovascular system & hematology Severity of Illness Index Article 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Predictive Value of Tests Risk Factors Surveys and Questionnaires Severity of illness medicine Humans Telemetry Oximetry Arthroplasty Replacement Knee Aged Sleep Apnea Obstructive medicine.diagnostic_test business.industry Sleep apnea Nerve Block General Medicine Length of Stay Middle Aged medicine.disease Arthroplasty Obstructive sleep apnea Analgesics Opioid Anesthesiology and Pain Medicine Treatment Outcome Predictive value of tests Anesthesia Female medicine.symptom Complication business |
| Popis: | Obstructive sleep apnea is associated with increased complication rates postoperatively. Current literature does not provide adequate guidance on management of these patients. This study used the STOP-Bang questionnaire to diagnose patients with possible obstructive sleep apnea (score ≥3). We hypothesized that a STOP-Bang score of 3 or greater would significantly correlate with the number of oxygen desaturation episodes during the first 48 hours after total knee arthroscopy.The STOP-Bang questionnaire was administered to 110 patients preoperatively. All patients underwent spinal-epidural anesthesia with a saphenous nerve block and sedation and were connected to the Nellcor OxiMax N-600x pulse oximeter for 48 hours postoperatively.Final analysis included 98 patients. There was no significant difference in the total number of desaturation events between STOP-Bang groups (score3 vs ≥3 and score5 vs ≥5). The total number of desaturation events on postoperative day 1 was greater than that on day 0 (32.8 ± 42.7 vs 4.1 ± 10.0, P0.0001). The total number of desaturation events correlated with length of hospital stay (r = 0.329, P = 0.0001). Patients with a preoperative serum CO2 of 30 mmol/L or greater had significantly longer episodes of desaturation on postoperative day 0 compared with CO2 of less than 30 mmol/L (233.7 ± 410.1 vs 82.0 ± 126.2 seconds, P = 0.044).A high preoperative value of CO2 should be a warning for possible prolonged episodes of desaturation postoperatively. An attempt to limit postoperative desaturation events should be made to minimize length of stay. |
| Databáze: | OpenAIRE |
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