Book contents
- Anesthesia Oral Board Review
- Anesthesia Oral Board Review
- Copyright page
- Contents
- Contributors
- Acknowledgments
- Letter from the Associate Editor
- How to Use This Book
- Format
- Applied Exam Tips for Success
- Part I General Information
- Part II Anesthetic-Related Critical Events and Information
- Section 1 Respiratory, Airway, and Ventilator Management
- Chapter 16 Hypoxemia and Hypercarbia
- Chapter 17 Indications for Intubation and Extubation
- Chapter 18 The Difficult Airway
- Chapter 19 Breathing Difficulties
- Chapter 20 Obstructive Sleep Apnea
- Chapter 21 Post-operative Mechanical Ventilation
- Chapter 22 High-Frequency Ventilation
- Chapter 23 One-Lung Ventilation
- Section 2 Cardiac, Thoracic, and Vascular Anesthesia
- Section 3 Neuroanesthesia
- Section 4 Renal and Urological
- Section 5 Hepatic and Gastrointestinal
- Section 6 Obstetric Anesthesia
- Section 7 Pediatric Anesthesia
- Section 8 Endocrine
- Section 9 Trauma Anesthesia
- Section 10 Emergency Events
- Section 11 Organ Transplant
- Section 12 Post-Anesthesia Care Unit
- Section 13 Acute and Chronic Pain
- Section 14 Other Situations
- Section 15 Safety and Ethics
- Index
- References
Chapter 20 - Obstructive Sleep Apnea
from Section 1 - Respiratory, Airway, and Ventilator Management
Published online by Cambridge University Press: 03 August 2023
- Anesthesia Oral Board Review
- Anesthesia Oral Board Review
- Copyright page
- Contents
- Contributors
- Acknowledgments
- Letter from the Associate Editor
- How to Use This Book
- Format
- Applied Exam Tips for Success
- Part I General Information
- Part II Anesthetic-Related Critical Events and Information
- Section 1 Respiratory, Airway, and Ventilator Management
- Chapter 16 Hypoxemia and Hypercarbia
- Chapter 17 Indications for Intubation and Extubation
- Chapter 18 The Difficult Airway
- Chapter 19 Breathing Difficulties
- Chapter 20 Obstructive Sleep Apnea
- Chapter 21 Post-operative Mechanical Ventilation
- Chapter 22 High-Frequency Ventilation
- Chapter 23 One-Lung Ventilation
- Section 2 Cardiac, Thoracic, and Vascular Anesthesia
- Section 3 Neuroanesthesia
- Section 4 Renal and Urological
- Section 5 Hepatic and Gastrointestinal
- Section 6 Obstetric Anesthesia
- Section 7 Pediatric Anesthesia
- Section 8 Endocrine
- Section 9 Trauma Anesthesia
- Section 10 Emergency Events
- Section 11 Organ Transplant
- Section 12 Post-Anesthesia Care Unit
- Section 13 Acute and Chronic Pain
- Section 14 Other Situations
- Section 15 Safety and Ethics
- Index
- References
Summary
A 54-year-old male is scheduled for a left knee arthroscopy for anterior cruciate ligament (ACL) reconstruction at an ambulatory center. The patient reports that a tooth was dislodged during a previous cholecystectomy. The patient has a past medical history significant for severe obstructive sleep apnea (OSA), where his previous sleep study indicated an apnea–hypopnea index (AHI) of 65 events per hour, minimum oxygen saturation 65% and mean oxygen saturation of 80%, and the patient spent 30% of total sleep time below oxygen saturation of 90%. The sleep study was done two years ago, and he gained some more weight due to the knee injury and limited physical activity. While he was advised to use positive airway pressure therapy, details of the machine settings were not known as he stopped using the machine a few months after the second therapeutic sleep study. He continues to snore loudly, his wife has observed him to have multiple “breathing stops” while asleep, he uses the bathroom 4–5 times per night, and is always found to be “sleepy” during the day. The patient has hypertension that is well controlled on a β-blocker and an ACE inhibitor. He has a blood pressure of 155/84 mm Hg, heart rate of 105, respiratory rate of 20, neck circumference of 45 cm, a temperature of 35.6 °C and current BMI of 48 kg/m2. His hematocrit is 49% and serum bicarbonate is 30 mmol/L. Is this patient a candidate for an outpatient surgery? How would you induce anesthesia? Would you prefer to do a regional or general anesthetic? Are you concerned that he is a difficult intubation? How would you manage his post-operative pain? Will he need special post-operative monitoring?
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- Anesthesia Oral Board ReviewKnocking Out The Boards, pp. 73 - 76Publisher: Cambridge University PressPrint publication year: 2023