Polysomnography after adenotonsillectomy in mild pediatric obstructive sleep apnea
- 1 August 1996
- journal article
- clinical trial
- Published by Wolters Kluwer Health in Critical Care Medicine
- Vol. 24 (8), 1323-1327
- https://doi.org/10.1097/00003246-199608000-00009
Abstract
A) To determine the need for intensive monitoring on the first operative night of surgery in children undergoing adenotonsillectomy for mild obstructive sleep apnea; b) to examine the effect of narcotics on postoperative obstructive sleep apnea. Randomized, prospective study. University hospital. Children, ranging in age between 1 and 18 yrs, presented to the Pediatric Otolaryngology Clinic for adenotonsillectomy for mild obstructive sleep apnea defined as from one to 15 obstructive apnea events per hour on preoperative polysomnogram. Patients were assigned to receive either a narcotic- or a halothane-based anesthetic for adenotonsillectomy. A postoperative polysomnogram was performed in the pediatric intensive care unit on the first operative night. Eighteen patients were recruited, 15 of whom met inclusion criteria: nine patients received a halothane-based anesthetic and six patients received a fentanyl-based anesthetic. When the data were analyzed by pooling both groups, the differences between pre- and postoperative sleep studies demonstrated a reduction in the number of obstructive events and less severe oxygen desaturations on the operative night. Total sleep time between the two sleep studies decreased from 371 +/- 13 to 304 +/- 14 mins. The number of obstructive apnea events/hr decreased as well. The lowest oxygen saturation measured during rapid eye movement sleep was 78 +/- 5% preoperatively and 92 +/- 1% postoperatively. Our data suggest that children without underlying medical conditions, neuromotor diseases, or craniofacial abnormalities, 1 to 18 yrs of age, who suffer from mild obstructive sleep apnea, have improvements documented by polysomnography on the night of surgery following adenotonsillectomy and do not necessarily need to be monitored intensively. These findings were not significantly affected by the choice of intraoperative anesthetic.Keywords
This publication has 14 references indexed in Scilit:
- Obstructive Sleep Apnea, Control of Ventilation, and Anesthesia in ChildrenPediatric Clinics of North America, 1994
- The Occurrence of Sleep-Disordered Breathing among Middle-Aged AdultsNew England Journal of Medicine, 1993
- Normal Polysomnographic Values for Children and AdolescentsAmerican Review of Respiratory Disease, 1992
- Respiratory Compromise After Adenotonsillectomy in Children With Obstructive Sleep ApneaJAMA Otolaryngology–Head & Neck Surgery, 1992
- Adenotonsillectomy for upper airway obstruction carries increased risk in children with a history of prematurityPediatric Pulmonology, 1992
- Current Indications for Tonsillectomy and AdenoidectomyAnnals of Otology, Rhinology & Laryngology, 1992
- Anesthesia with Abdominal Surgery Leads to Intense REM Sleep during the First Post-operative WeekAnesthesiology, 1990
- ADENOTONSILLAR HYPERTROPHY AND COR PULMONALEBritish Journal of Anaesthesia, 1988
- Mortality and Apnea Index in Obstructive Sleep ApneaChest, 1988
- Electrocardiographic signs of pulmonary hypertension in children who snore.BMJ, 1981