What happens to CSA people under general anesthesia ? Do we just stop breathing?

[Geer1]

Pretty much everyone stops breathing under general anesthetic, it is part of the process.

Central apnea will have no effect except perhaps in the recovery period when waking up after surgery. It just means that they might need to keep you on the ventilator and/or oxygen longer or potentially until you are fully awake.

Lots of people seem to worry about the effects of apnea when on anesthesia but I think these people don't realize that it stops everyone from breathing and that the doctors have the equipment and knowledge to make everyone breath regardless of what their body wants to do. At most you can mention to the doctor you have central or obstructive apnea as a heads up so they are aware of it and expect it. Even if you don't they will keep you breathing/oxygenated though.

[Ratchick]

You should, absolutely, mention it as it may affect the choice of medication they choose to give you, as well as ensures that they will watch you more thoroughly in recovery and make sure you're supported properly, if necessary. That's where the real issues might arise. But absolutely, during the surgery itself (if it's properly under general anaesthesia and not twilight sedation) then part of the process is to knock you out and stop you from breathing so they can manage it. Some twilight procedures are different, but if the anesthesiologist knows ahead of time, then either they will modify the anaesthesia given, or they'll ensure that your breathing is protected in some other way. 

Definitely not something to be concerned about, though.

[archangle]

Your real risk will be post-op recovery.  The medical mafia is now heavily into assembly line medicine.  The anesthesia team dumps you into the recovery team and they tend not to talk to each other.  You can't even count on the recovery team to put on your CPAP if you have one. 

I have a buddy who doesn't do CPAP and despite warning them multiple times about breathing problems in previous anesthesia recovery rooms, they STILL dumped him in the recovery room unable to stay awake and with no one watching him.  It was like two different companies doing the anesthesia and they didn't talk to each other.  He was having problems in the recovery room, and had a friend watching him.  When his friend noticed he was having trouble breathing, there was no qualified medical person on site, and almost no one who cared.

[Horseshoez]

I got attacked by two 150+ pound dogs back in July and woke up 30 hours later in our friendly neighborhood ICU.  During those 30 hours I underwent a number of evaluations to determine the extent of my injuries, Grade IIIb concussion, bitten abdomen with no surgery required, and a badly bitten right leg requiring surgery.  However, prior to all of that the hospital staff intubated me and put into a medically induced coma, both for my protection as well as that of the hospital staff (apparently I was violently defensive whenever someone would try to touch me or move me into a different setting like the CT Scan).

Waking up caused things to go from bad to worse, unfortunately for me I was blind from the drugs (Fentanyl) they gave me to induce a coma, I couldn't speak due to the intubation, and I was bound arms and legs.  Yeah, I flipped out while trying to get the restraints off; a doctor pulled my wife aside and asked about my military background and whether I'd ever endured extended periods of abuse (yes, but not while I was in the Marines); the instant the doctor learned my history, he ordered me released from restraints and extubated, I calmed right down and..., a series of apnea events immediately followed.  Fortunately my wife anticipated this and had my CPAP at the ready; she helped the nursing staff get it on me and I slept a few more hours before finally waking up and being informed of how badly I'd been injured.

I don't know if most hospitals allow patients to provide their own PAP devices, but I am super grateful this hospital did.

[S.Huxley]

Nothing happens. Like other posters have mentioned you should tell your medical team about your condition. Even if you don't mention it, your anethisitian will be monitoring your breathing and other vital signs throughout the procedure and will ensure you keep breathing.
In your post up though no one is watching you because you'll be hooked up remotely with your vitals and if you stop breathing all kinds of bells and whistles will go off, except that even with CSA your body will wake you up to breath if you stop, so I wouldn't worry too much about it, except if you end up with very poor medical care, in which case you absolutely need to go in prepared with your machine and someone who will be by your bed side in post op.

[Bert S]

Funny story: I had an endoscopy and when I woke up they all stood around me and I wondered what happened. Doc told me that he had to abort the procesure because I stopped breathing. Sent me to a pulmonologist and cardiologist to find out what's wrong. THTA"S how I found out that I have sleep apnea - I had not clue.

At 2nd try, I asked anesthesiologist what he was doing differently now that he knew I have sleep apnea. Answer: 1) eliminate the opioids from the drug cocktail because he said they found people with sleep apnea are more "sensitive" to opioids (whatever that means) and 2) administer more oxygen via mask, not the little prongs they usually put under your nose. 

Procedure went fine, but doc told me that I had one apnea when my head dropped.

Anyway, took me not waking up during procedure to learn I have sleep apnea - maybe a blessing in disguise...now I just have to get the therapy right.

[cathyf]

...except if you end up with very poor medical care, in which case you absolutely need to go in prepared with your machine and someone who will be by your bed side in post op.

Great advice, except that now with COVID you can't have visitors and they can just kill you from neglect with nobody to stop them!

[offline]

I'm a tech in surgery. CSA/OSA is not a problem and there is no need to be concerned.

In fact some patients only find out they have CSA/OSA in hospital.

When the breathing tube is removed at the end of surgery, a tighter hold might need to be placed on the jaw, and the head tilted back a bit more. This fixes any obstruction. A special bag can be used to push extra breaths if needed. Sometimes patients have no idea they have apnea, and a sleep test is recommended.

One thing we can do is give extra oxygen before going to sleep. This buys the Dr more time to put the tube down once the anesthetic stops your breathing.

If you are only having sedation, say for a minor day procedure, we might be more likely to run some high flow oxygen (not dissimilar to a CPAP.)

Either way, your ABC's (airway, breathing, circulation) are going to be better taken care of in the operating room than in your own bed.

[DaveCar]

Funny story: I had an endoscopy and when I woke up they all stood around me and I wondered what happened. Doc told me that he had to abort the procesure because I stopped breathing. Sent me to a pulmonologist and cardiologist to find out what's wrong. THTA"S how I found out that I have sleep apnea - I had not clue.

Years before I was diagnosed with severe OSA (they said I hit 85), I had an oral surgery under general.  When I went back to have the stitches removed, I noticed my charts on the wall. There was an area of graph activity with quite different lines that they had circled in red with some writing I couldnt read from where I sat in the procedure room.  Doc didnt mention it, I didnt ask..  but in retrospect, I wonder if someone said hey, you should tell this guy he has OSA or such, but they got busy and forgot.   I could have had a 5+ year head-start on my CPAP, and avoided totalling a vehicle maybe.