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GENERAL ARTICLES

The Impact of Postoperative Nasal Packing on Sleep-Disordered Breathing and Nocturnal Oxygen Saturation in Patients with Obstructive Sleep Apnea Syndrome

Adrian Regli, MD^*, Britta S. von Ungern-Sternberg, MD^*, Werner M. Strobel, MD, Hans Pargger, MD^*, Antje Welge-Luessen, MD, and Adrian Reber, MD, PhD

*Department of Anesthesia and Operative Critical Care, Division of Pneumology, Department of Internal Medicine, and Ear, Nose and Throat Department, University Hospital, Basel, Switzerland; and Department of Anesthesiology and Intensive Care Medicine, Hospital Zollikerberg, Switzerland

Address correspondence and reprint requests to Adrian Regli, MD, Department of Anesthesia and Operative Critical Care, University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland. Address e-mail to aregli{at}uhbs.ch.

Nasal septum surgery is frequently performed to establish a functional nasal airway. In these patients obstructive sleep apnea syndrome (OSAS) is frequently present. Although patients with OSAS are at increased risk for hypoxemia, the impact of postoperative nasal packing (PNP) on sleep-disordered breathing and oxygen desaturations in patients with OSAS is unknown. We consecutively investigated 40 patients undergoing endonasal surgery receiving PNP. Fifteen of these patients had previously diagnosed OSAS (Group 2) and 25 did not (Group 1). In the control group, 12 healthy patients underwent elective ear or neck surgery without PNP. During the preoperative and postoperative nights, we continuously measured oronasal flow, thoracoabdominal movements, and oxygen saturation. We calculated the apnea-hypopnea index (AHI) and the oxygen-desaturation index (ODI). Compared with the preoperative values, after the operation, neither AHI nor ODI changed in the control group. In contrast, in Group 1, AHI (from 11 [5–19] to 37 [22–49]) and ODI (from 4 [2–8] to 13 [6–21]) significantly increased (P < 0.05), whereas in Group 2, only AHI significantly increased (from 14 [10–21] to 39 [26–50]); ODI remained similar (13 [8–27] versus 11 [4–37]). Because ODI did not increase in patients with OSAS and PNP who received postoperative oxygen overnight, postoperative intensive care monitoring might not be necessary on a routine basis for all patients with PNP and OSAS.

This article has been cited by other articles:

				W. T. McNicholas The nose and OSA: variable nasal obstruction may be more important in pathophysiology than fixed obstruction Eur. Respir. J., July 1, 2008; 32(1): 3 - 8. [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999