Evidence-based Review and Recommendations for Intraoperative Management of Patients With Sleep Apnea

More than a decade after the first publication of ASA’s Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea,¹  the approach to patients with suspected or diagnosed obstructive sleep apnea (OSA) remains a topic of intense debate. To date, significant energy and focus has gone into the recognition of OSA as a perioperative risk factor for complications and adverse events.²  Also, a number of expert groups have attempted to guide clinicians in the perioperative care of patients with OSA, with considerable focus on preoperative screening and post-operative management. However, evidence-based approaches to the anesthetic care of this patient population remain unclear. Thus, guidance in respect to intraoperative management specific to patients with OSA with the goal to optimize outcomes has received less attention. It is therefore not surprising that real-world practice variability in our...