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Perioperative management of obstructive sleep apnea with nasal continuous positive airway pressure. 2008

Hirofumi Arisaka, and Shigeki Sakuraba, and Reiko Kobayashi, and Homare Kitahama, and Naofumi Nishida, and Munetaka Furuya, and Kazu-ichi Yoshida
Division of Anesthesiology, Department of Clinical Care Medicine, Kanagawa Dental College, Kanagawa, Japan. a-hiroumi@mpg.biglobe.ne.jp

The high risks associated with general anesthesia in obstructive sleep apnea syndrome (OSAS) patients have been reported. Many authors have suggested that the intraoperative administration of opioids and sedatives should be limited or avoided because these drugs selectively impair muscle activity in the upper airway. We report the case of an OSAS patient who was managed with nasal continuous positive airway pressure (NCPAP) and treated safely in spite of the use of conventional anesthetic and analgesic agents typically used for patients without OSAS. She had little pain during the perioperative period. It is suggested that NCPAP is an effective treatment for not only preventing airway obstructive apnea but for allowing the administration of anesthetic and analgesic drugs without major complications.

UI MeSH Term Description Entries
D007442 Intubation, Intratracheal A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia. Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D008408 Mastectomy Surgical procedure to remove one or both breasts. Mammectomy,Mammectomies,Mastectomies
D009294 Narcotics Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS. Analgesics, Narcotic,Narcotic Analgesics,Narcotic,Narcotic Effect,Narcotic Effects,Effect, Narcotic,Effects, Narcotic
D010423 Pentazocine The first mixed agonist-antagonist analgesic to be marketed. It is an agonist at the kappa and sigma opioid receptors and has a weak antagonist action at the mu receptor. (From AMA Drug Evaluations Annual, 1991, p97) Fortral,Lexir,Pentazocine Hydrochloride,Pentazocine Lactate,Talwin,Hydrochloride, Pentazocine,Lactate, Pentazocine
D003422 Critical Care Health care provided to a critically ill patient during a medical emergency or crisis. Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D005260 Female Females
D005283 Fentanyl A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078) Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006919 Hydroxyzine A histamine H1 receptor antagonist that is effective in the treatment of chronic urticaria, dermatitis, and histamine-mediated pruritus. Unlike its major metabolite CETIRIZINE, it does cause drowsiness. It is also effective as an antiemetic, for relief of anxiety and tension, and as a sedative. 2-(2-(4-((4-Chlorophenyl)phenylmethyl)-1-piperazinyl)ethoxy)ethanol,Atarax,Durrax,Hydroxyzine Dihydrochloride,Hydroxyzine Hydrochloride,Hydroxyzine Pamoate,Orgatrax,Vistaril,Pamoate, Hydroxyzine
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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