Correlação entre síndrome da apneia obstrutiva e via aérea difícil na cirurgia otorrinolaringológica

• Ano de defesa: 2017
• Autor(a) principal: Pera, Marcia Hiray [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Sleep apnea; Oropharynx; Intubation; Questionnaire; Risk factor; Surveys and questionnares; Apneia do sono; Orofaringe; Intubação; Fatores de risco; Inquéritos e Questionários
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5454417; http://repositorio.unifesp.br/handle/11600/49960

Introduction: Otorhinolaryngological surgical patients with obstructive sleep apnea syndrome (OSAS) present, besides anatomical obstacles, a tendency to collapse of the upper airways (UA). OSAS is related to a higher risk of difficult airway (DA) and also increased perioperative complications, since drugs used in sedation or general anesthesia have a depressor effect that lead to worsening UA obstruction. In order to identify these patients in the preoperative period, the STOP BANG questionnaire has been highlighted, as it is summarized and easy to apply. Objectives: To evaluate whether patients undergoing otorhinolaryngological surgery with a diagnosis of OSAS using the STOP BANG questionnaire would present a higher risk of complications, particularly the occurrence of a difficult airway. Cases and methods: 48 patients undergoing otorhinolaryngological surgery, with a previous polysomnographic study, were analyzed for demographic characteristics, anamnesis, physical examination, and anatomical parameters measurements for difficult airways, in addition to the preoperative examinations. Then, the STOP BANG questionnaire was administered to the patient. Results: The present sample detected a difficult airway in about one fifth of otorhinolaryngological patients, all of them with OSAS, confirmed by polysomnography. This group had older age, cervical circumference greater than 40 cm, ASA II, Cormack III and IV. On the other hand, patients with OSAS presented higher body mass index, cervical circumference and observed apnea frequency. In the subgroup analysis, the group with severe OSAS showed a significantly higher score at Stop Bang when compared with patients without OSAS or with mild / moderate OSAS. CONCLUSIONS: The STOP BANG questionnaire was not able to predict DA and mild to moderate OSAS, but it predicted severe OSAS. All patients undergoing otorhinolaryngologic surgery with DA had OSAS confirmed by polysomnography, although OSAS did not implicate DA .The variables Cormack III, IV and BMI greater than 35 kg.m.2 were able to predict DA and OSAS respectively.