Volumen 64,Numero 1, Suplemento SAHOS, Revista de la Facultad de Medicina

Publicado

2017-08-02

Manejo perioperatorio del paciente con síndrome de apnea-hipopnea obstructiva del sueño (SAHOS)

Perioperative management of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS)

Palabras clave:

Apnea del sueño obstructiva, Procedimientos quirúrgicos operativos, Complicaciones intraoperatorias, Anestesia, Hipnóticos y Sedantes. (es)
Sleep Apnea, Obstructive, Surgical Procedures, Operative, Intraoperative Complications, Anesthesia, Hypnotics and Sedatives. (en)

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Autores/as

  • Angélica Fajardo-Escolar Pontificia Universidad Javeriana - Hospital Universitario San Ignacio - Bogotá D.C. - Colombia.
  • Ana Helena Perea-Bello Pontificia Universidad Javeriana - Hospital Universitario San Ignacio - Bogotá D.C. - Colombia.
  • Patricia Hidalgo-Martinez Pontificia Universidad Javeriana - Hospital Universitario San Ignacio - Clínica del Sueño - Bogotá D. C. - Colombia.
Los pacientes con diagnóstico de síndrome de apnea-hipopnea obstructiva del sueño (SAHOS) pueden ser llevados de forma segura a cualquier procedimiento quirúrgico, incluso de manera ambulatoria si tienen control adecuado de sus otras comorbilidades. El tratamiento con presión positiva continúa en vía aérea (CPAP) en pacientes con diagnóstico confirmado disminuye el riesgo de presentar complicaciones cardiovasculares a largo plazo. La sedación debe ser hecha por un anestesiólogo, quien, además, debe vigilar al paciente y disponer del equipo adecuado para atender complicaciones respiratorias emergentes. Se sugiere que, en estos pacientes, los procedimientos sean hechos en el ámbito hospitalario, donde se tenga disponibilidad en la unidad de cuidados post-anestésicos y personal para monitoreo por al menos una hora tras finalizar el procedimiento. El tratamiento con CPAP debe continuar según sea ordenado por el médico tratante. Es importante que desde la valoración preanestésica se identifique a los pacientes con riesgo de SAHOS para lograr trazar un plan anestésico que disminuya las complicaciones a nivel respiratorio y del manejo de la vía área.

Patients diagnosed with obstructive sleep apnea-hypopnea syndrome (OSAHS) can safely undergo a surgical procedure, even on an outpatient basis, if other comorbidities are adequately controlled. Continuous positive airway pressure (CPAP) treatment in patients with a confirmed diagnosis decreases the risk of long-term cardiovascular complications. Sedation should be done by an anesthesiologist, who must also monitor the patient and have the appropriate equipment to deal with emerging respiratory complications.

Procedures undergone by these patients should be performed in a hospital setting, in which a post-anesthetic care unit and staff are available for follow-up, at least for an hour after the procedure ends. CPAP treatment should be continued as ordered by the treating physician. Identifying patients with OSAHS risk during the preanesthetic evaluation is important to propose an anesthetic plan that reduces respiratory complications and improves airway management.

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Citas

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