Management of OSA on Day of Surgery
It is impossible to be prescriptive about the management of OSA in the perioperative period. There is a wide spectrum of surgical procedures and no consideration is given here to patient comorbidity or fitness for anaesthesia. These recommendations should be considered guidelines and do not replace clinical acumen.
These guidelines also only refer to patients receiving general anaesthesia or sedation. There is no evidence to support altering practise for patients with OSA who are receiving only local or regional anaesthesia.
Patient is known to have OSA
Patient has a known diagnosis of OSA - either established or newly diagnosed in the process of pre-operative screening
Patient has intermediate or high probability of moderate/severe OSA
In this group, patients have been identified by pre-operative screening to have an intermediate or high probability of moderate/severe OSA but the patient has not had a sleep study to make the diagnosis.
Patients who have been identified to be at low probability of moderate/severe OSA require no adaptation to their management
It is important to remember that a proportion of patients will not have OSA. Therefore, interventions are being taken for a disease that they may not have.