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Prevalence and Management of Obstructive Sleep Apnea in Patients Undergoing Total Joint Arthroplasty

Authors
Journal
The Journal of Arthroplasty
0883-5403
Publisher
Elsevier
Publication Date
Volume
25
Issue
6
Identifiers
DOI: 10.1016/j.arth.2010.04.034
Keywords
  • Obstructive Sleep Apnea (Osa)
  • Total Joint Arthroplasty (Tja)
  • Intrathecal Narcotic (In)
  • Hypoxia
  • Upper Airway Patency
Disciplines
  • Medicine

Abstract

Abstract Obstructive sleep apnea (OSA) may be a risk factor for complications after total joint arthroplasty (TJA). We sought to determine the prevalence of OSA in patients undergoing TJA, and the safety and effectiveness of intrathecal narcotic (IN) in these patients. We retrospectively reviewed 1255 consecutive patients undergoing 1463 TJA at one hospital. All patients underwent routine screening for OSA and IN anesthesia, with 109 patients (134 TJA) identified with OSA (8.7%). Compared with 127 randomly selected patients (141 TJA) without OSA, OSA patients were significantly heavier and had higher American Society of Anesthesiologists scores, more comorbidities, longer length of stay, more transient hypoxia, more transfusions, and more medical variances. Despite more minor variances, with appropriate screening and management, OSA patients did not have a higher rate of significant or major complications. Length of stay, although longer, was only 2.3 days in OSA patients, demonstrating the safety and efficacy of IN anesthesia in these patients.

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