Risks of general anaesthesia in people with obstructive sleep apnoea

doi:10.1136/bmj.329.7472.955

BMJ 2004;329:955-959 (23 October), doi:10.1136/bmj.329.7472.955

Clinical review

Risks of general anaesthesia in people with obstructive sleep apnoea

Cindy den Herder, resident in ear, nose, and throat surgery¹, Joachim Schmeck, specialist registrar in anaesthesiology and intensive care medicine³, Dick J K Appelboom, specialist registrar in anaesthesiology², Nico de Vries, specialist registrar in ear, nose, and throat surgery¹

¹ Department of Otolaryngology/Head and Neck Surgery, St Lucas Andreas Hospital, Jan Tooropstraat 164, 1006 AE, Amsterdam, Netherlands, ² Department of Anaesthesiology, St Lucas Andreas Hospital, ³ Department of Anaesthesiology and Operative Intensive Care Medicine, University Hospital Mannheim, University of Heidelberg Theodor-Kutzer-Ufer, D-68167, Mannheim, Germany

Correspondence to: C den Herder c.denherder@slaz.nl

The first 150 words of the full text of this article appear below.

Introduction

Sleep is an integral part of human existence and is now, morethan ever, the subject of clinical and research interest. Whydo we spend approximately one third of our lives asleep? Sleepprobably has a recovery function, especially for the brain.Throughout rapid eye movement sleep, neuronal connections inthe catecholamine system are created, and this activity is essentialto maintain cognitive function.^w1 During rapid eye movementsleep in particular, the body is at its most relaxed state,and a three dimensional collapse of muscle (musculus genioglossusand musculus geniohyoideus) and fatty tissue around the upperairway may cause obstruction.¹ When a pre-existent narrowingand slackening of the upper airway is also present,² apnoeas(complete cessation of breathing for 10 seconds or more) orhypopnoeas (> 50% diminishing of airflow or oxygen desaturations> 3% for 10 seconds or more) may result. The prevalence ofobstructive sleep apnoea in . . . [Full text of this article]

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Preoperative aspects

Perioperative aspects

Postoperative aspects

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Obstructive sleep apnoea (OSA): M Thirumaran
bmj.com, 24 Oct 2004 [Full text]
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Evidence based anaesthesia?: Michael Foley
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The compelling incentive to eradicate mutant anaesthetic memes and meme complexes.: Richard G Fiddian-Green
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A Misleading Title: Andrew P Syndercombe, et al.
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