[Correlation between obstructive apnea syndrome and difficult airway in ENT surgery].

[Correlation between obstructive apnea syndrome and difficult airway in ENT surgery].

Rev Bras Anestesiol. 2017 Dec 20;:

Authors: Pera MH, Tardelli MA, Novo NF, Juliano Y, Silva HCAD

Abstract
INTRODUCTION: ENT patients with obstructive sleep apnea syndrome have, in addition to anatomical obstacles, a tendency of collapsing the upper airways. Obstructive sleep apnea syndrome is related to the increased risk of difficult airway and also increased perioperative complications. In order to identify these patients in the preoperative period, the Stop Bang questionnaire has been highlighted because it is summarized and easy to apply.
OBJECTIVES: Evaluate through the Stop Bang questionnaire whether patients undergoing ENT surgery with a diagnosis of obstructive sleep apnea syndrome have a higher risk of complications, particularly, the occurrence of difficult airway.
CASUISTRY AND METHODS: Measurements of anatomical parameters for difficult airway and questionnaire application for clinical prediction of obstructive sleep apnea syndrome were performed in 48 patients with a previous polysomnographic study.
RESULTS: The sample detected difficult airway in about 18.7% of patients, all of them with obstructive sleep apnea syndrome. This group had older age, cervical circumference > 40cm, ASA II and Cormack III/IV. Patients with obstructive sleep apnea syndrome had higher body mass index, cervical circumference, and frequent apnea. In subgroup analysis, the group with severe obstructive sleep apnea syndrome showed a significantly higher SB score compared to patients without obstructive sleep apnea syndrome or with mild/moderate obstructive sleep apnea syndrome.
CONCLUSIONS: The Stop Bang questionnaire was not able to predict difficult airway and mild obstructive sleep apnea syndrome, but it identified marked obstructive sleep apnea syndrome. All patients with difficult airway had moderate and marked obstructive sleep apnea syndrome, although obstructive sleep apnea syndrome did not involve difficult airway. The variables Cormack III/IV and BMI greater than 35 Kg.m-2 were able to predict difficult airway and obstructive sleep apnea syndrome, respectively.

PMID: 29274675 [PubMed - as supplied by publisher]

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