General Anesthesia and OSA

[MyronH]

I'm scheduled to have a couple of procedures done, a colonoscopy and gallbladder removed. I've read some disturbing article over on sleepApnea org site, warning anesthetists about people with OSA. I doubt I can bring my machine to use during the procedures, since it will be done in a surgical center. Are anesthetists fairly aware these days about working with people with OSA? Do they know what to do with people that have OSA?

[Crimson Nape]

You should have a per-surgical consult with the Anesthetist. Inform them that you use a CPAP. No biggie, they just inserted an airway in me after I was out. You might experience a sore throat for a few days afterward.

[chill]

What Red said.  I am not sure if they tubed me or not.  I did not notice a sore throat but lots else was sore so I may have missed it.  I'd bring your machine.  They put me on mine in the post-op recovery room as I kept getting into low oxygen saturation terriority.   Most of the time I had dedicated nurse sitting next to me reminding me to breath until the anesthetic wore off.  Not sure which of us was more annoyed.  

[car54]

I am having a surgery today under general anesthesia. During the preop interview they asked if I have sleep apnea. Because I do they said that I should bring the machine in just in case it is needed. I am guessing that it may be used in the recovery room and not during surgery.

MyronH, I would bring it in. It would not hurt to have it there.

In my previous surgery's they have never used it but its better to play it safe.

car54

[Sleep2Snore]

Are Anaesthetists fairly aware these days about working with people with OSA?

They are over here, they told me not to worry as they have enough equipment to keep you breathing during the operation.
It is advisable to tell them in advance so as they can prepare for you going to theatre and make sure you stay alive.
So as long as you tell them, I am told you are at no more risk than anyone else.

[OpalRose]

MyronH,
The hospital should call you for a preadmission consult before the surgery.  With a colonoscopy, you shouldn't have to worry, as it lasts a little under an hour and you are laying on your side.  

Gall Bladder surgery takes a little longer and you will be under general anesthesia.  Be sure the doctor, nurses and especially the anesthesiologist know you have SA and what machine you use.  Talk to them about what precautions they will take when monitoring you.  For the gall bladder surgery, you will probably have a breathing tube inserted.

It's a good idea to bring your machine or have a family member hold on to it.  They normally don't let you bring that into the surgical room, but you may be allowed to use it in recovery if needed.  

I've had both those procedures done. You just have to speak up ahead of time so that the docs are aware.

[SarcasticDave94]

Actually had colonoscopy and other surgeries since sleep apnea diagnosis. Anesthesia tech had visited during surgery prep, each time asked about special situations including apnea. Make certain to mention apnea by type here. They stated they'd be ready for it, in each of my cases. Only one so far had to do oxygen tubing thru nose down throat to assist during surgery. Not been an issue.

[Crimson Nape]

I forgot to mention that endoscopies and colonoscopies at regarded as "light sleep" using Propofol and normally don't require any special consideration. These procedures require being orientated on your side.   The major concern for these procedures is making sure you are aimed the correct way.    

Now surgery requires them to place you in a deeper state of sleep and is where the airway might come into play.  Fortunately, CPAP usage has been around long enough that it is not a major concern during surgery.  I suspect that they have to be on guard about is a patient that has SA and doesn't know it.  I would guess that this happens all too often.

[SarcasticDave94]

FWIW besides colonoscopy, I had a shoulder scope, the bariatric sleeve surgery, and spinal implant trial. I was "out" for scope and bariatric. No issues.

[PaulaO2]

Make sure that whatever human accompanies you understands how to attach you to the mask and how to operate the machine. Practice ahead of time.

Some hospitals will not allow you to bring your own machine but "rent" you one at a very high price. Depends on how you are paying the bill, I think. The rental for my neck surgery would have cost $600 a day, not including the RT.

During the recovery, they may just ignore the snoring in order to do their thing. Or sit you up.

Bring your own oxygen hose to CPAP hose adapter in case it is needed.