코골이 및 수면 무호흡증으로 수술적 치료를 받은 환자들의 수술 전 진료 의뢰 분석
Analysis of Preoperative Consultations of Patients With Snoring and Sleep Apnea
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Obstructive Sleep Apnea (OSA) is well known as a risk factor in the hypertension, cardiovascular and cerebrovascular diseases and other metabolic diseases. Therefore, preoperative evaluation in OSA patients is very important to discover comorbid diseases and other risk factors for anesthesia and surgery itself. We tried to find out the incidence of consultation to other department and incidence of risk factors. Subjects and Method：195 patients who received surgery due to OSA and snoring were included. We analyzed consultation history to other department for evaluation of risk in surgery and anesthesia, by going through past medical history, laboratory tests, chest radiographs, and electrocardiograms, etc., in the medical records. Results：38.5% (75 patients) of the patients were consulted to other department. The causes of consultation were liver problems, abnormal chest PA, hypertension, diabetes mellitus, etc., in the order of frequency. Only 17 patients were newly diagnosed by consultation. The rate of consultation was significantly correlated with the severity of OSA by apneahypopnea index and minimal oxygen saturation. Conclusion：The patients with OSA need several consultations for evaluation of operative and anesthetic risk, especially in the severe OSA. Therefore, OSA patients should be evaluated precisely, and managed carefully. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:331-5)
Abstract
Obstructive Sleep Apnea (OSA) is well known as a risk factor in the hypertension, cardiovascular and cerebrovascular diseases and other metabolic diseases. Therefore, preoperative evaluation in OSA patients is very important to discover comorbid diseases and other risk factors for anesthesia and surgery itself. We tried to find out the incidence of consultation to other department and incidence of risk factors. Subjects and Method：195 patients who received surgery due to OSA and snoring were included. We analyzed consultation history to other department for evaluation of risk in surgery and anesthesia, by going through past medical history, laboratory tests, chest radiographs, and electrocardiograms, etc., in the medical records. Results：38.5% (75 patients) of the patients were consulted to other department. The causes of consultation were liver problems, abnormal chest PA, hypertension, diabetes mellitus, etc., in the order of frequency. Only 17 patients were newly diagnosed by consultation. The rate of consultation was significantly correlated with the severity of OSA by apneahypopnea index and minimal oxygen saturation. Conclusion：The patients with OSA need several consultations for evaluation of operative and anesthetic risk, especially in the severe OSA. Therefore, OSA patients should be evaluated precisely, and managed carefully. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:331-5)
참고문헌 (20)
- Fletcher EC, "Sympathetic activity and blood pressure in the sleep apnea syndrome", Respiration, 64(1), pp.22~28 (1997)
- Nierman E, "Recognition and management of preoperative risk", Rheum Dis Clin North Am, 25(3), pp.585~622 (1999)
- Cartagena R, "Preoperative evaluation of the patients with obesity and obstructive sleep apnea", Anesthesiol Clin North America, 23(3), pp.463~478 (2005)
- Jarrell L, "Preoperative diagnosis and postoperative management of adult patients with obstructive sleep apnea syndrome: A review of literature", J Perianesth Nurs, 14(4), pp.193~200 (1999)
- Strollo PJ, "Obstructive sleep apnea", N Engl J Med, 334(2), pp.99~104 (1996)
- Tanné F, "Chronic liver injury during obstructive sleep apnea", Hepatology, 41(6), pp.1290~1296 (2005)
- Guilleminault C, "Chronic obstructive airflow disease and sleep studies", Am Rev Respir Dis, 122(3), pp.397~406 (1980)
- Fletcher EC, "Long-term cardiopulmonary sequelae in patients with sleep apnea and chronic lung disease", Am Rev Respir Dis, 135(3), pp.525~533 (1997)
- Krieger J, "Pulmonary hypertension, hypoxemia, and hypercapiea in obstructive sleep apnea patients", Chest, 96(4), pp.729~737 (1989)
- Chaout A, "Association of chronic obstructive pulmonary disease and sleep apnea syndrome", Am J Respir Crit Care Med, 151(1), pp.82~86 (1995)
- Flenley DC, "Sleep in chronic obstructive lung disease", Clin Chest Med, 6(4), pp.651~661 (1985)
- Young T, "Population-based study of sleep-disordered breathing as a risk factor for hypertension", Arch Intern Med, 157(15), pp.1746~1752 (1997)
- Hall MJ, "Cardiovascular disease and sleep apnea", Curr Opin Pulm Med, 1(6), pp.512~518 (1995)
- Chung YS, "Prevalence of the associated disease in patients with snoring and sleep apnea", Korean J Otolaryngol-Head Neck Surg, 44(3), pp.283~287 (2001)
- Marin JM, "Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: An observational study", Lancet, 365(9464), pp.1046~1053 (2005)
- Scharf SM, "Cardiovascular effects of periodic occlusions of the upper airway in dogs", Am Rev Respir Dis, 146(2), pp.321~329 (1992)
- Guilleminault C, "Cyclical variation of the heart rate in sleep apnea syndrome", Lancet, 1(8369), pp.126~131 (1984)
- Palmoke H, "Snoring and the risk of ischemic brain infarction", Stroke, 22(8), pp.1021~1025 (1991)
- Somers VK, "Sympathetic neural mechanisms on obstructive sleep apnea", J Clin Invest, 96(4), pp.1897~1904 (1995)
- Somers VK, "Parasympathetic hyperresponsiveness and bradyarrhythmias during apnoea in hypertension", Clin Auton Res, 2(3), pp.171~176 (1992)