Risks of hypoxemia after uvulopalatopharyngoplasty in patients with obstructive sleep apnea syndrome / 中华麻醉学杂志

ABSTRACT

Objective To observe the risks of hypoxemia after uvulopalatopharyngoplasty (UPPP) in patients with obstructive sleep apnea syndrome (OSAS).Methods Forty-six ASA Ⅱ or Ⅲ male patients with OSAS,aged 30-50 yr,with body mass index 27-33 kg/m2,Mallampati Ⅰ-Ⅳ,underwent UPPP under general anesthesia with propofol and remifentanil.O2 was inhaled for 24 h via a nasal catheter starting from the end of surgery.SpO2 was monitored within 24 h after surgery.Oxygen desaturation index (ODI,hourly average number of desaturation episodes in which the decrease in SpO2 ≥4% and duration ≥ 10 s) and the cumulative time percentage with SpO2 ＜ 90% (CT90) from oximetry were recorded.Results Compared with the baseline value before surgery,ODI and CT90 were significantly decreased at 2 and 2-4 h after extubation and on 1 st night after surgery (1100 pm-600 am) (P ＜ 0.05).ODI and CT90 were significantly lower on 1st night after surgery than at 2 and 2-4 h after extubation (P ＜ 0.05).The rate of ODI abnormalities was 100%,48% and 50% before surgery and at 2 and 2-4 h after extubation,respectively.Compared with the baseline value before surgery,the rate of ODI abnormalities was significantly decreased at 2 and 2-4 h after extubation,while increased on 1 st night after surgery (P ＜ 0.05).There was no significant difference in the rate of ODI abnormalities between that on 1 st night after surgery and that before surgery (P ＞ 0.05).Conclusion Although UPPP can significantly improve airway obstruction in patients with OSAS,hypoxemic episodes still occur after surgery,suggesting that UPPP should not be treated as an ambulatory surgery.