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- W2037797652 abstract "The recent update of the report “Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea” by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Obstructive Sleep Apnea did not provide any new recommendations.1 Like its predecessor, the updated version includes “table 2,” a scoring system for perioperative risk for obstructive sleep apnea. This table allows the reader to assign a numerical score for severity of sleep apnea, invasiveness of surgery and anesthesia, and requirement for postoperative opioids. The overall score yields an estimate of perioperative risk. By its very design, the scoring system appears scientific and precise.A footnote to the table states: “This example, which has not been clinically validated, is meant only as a guide, and clinical judgment should be used to assess the risk of an individual patient.” Many readers may miss this subtle point, and confuse the table with a reliable means for stratifying risk for postoperative respiratory complications, as well as the need for postoperative respiratory monitoring. Risk stratification for opioid-induced respiratory depression is by no means an exact science, and failure to rescue remains a significant source of human suffering and healthcare expense. The Anesthesia Patient Safety Foundation recognizes this fact, and has stated “…risk stratification for increased postoperative electronic monitoring would potentially miss a large population of patients that is at increased risk for opioid-induced respiratory depression.”2 Not surprisingly, the Anesthesia Patient Safety Foundation has advocated for continuous respiratory monitoring for all postoperative patients receiving parenteral opioids.By all means, practice guidelines should help providers make sound clinical decisions when solid scientific evidence is lacking. The inclusion of an untested numerical risk assessment scale, however, has no place in such a document, even if there is a disclaimer in the fine print.The author declares no competing interests." @default.
- W2037797652 created "2016-06-24" @default.
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- W2037797652 date "2014-09-01" @default.
- W2037797652 modified "2023-10-18" @default.
- W2037797652 title "Read the Fine Print: Updated Sleep Apnea Guidelines and Risk Stratification" @default.
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- W2037797652 doi "https://doi.org/10.1097/aln.0000000000000355" @default.
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