OSA in children as a risk factor for surgery – is postoperative monitoring justified?

Introduction:

Obstructive sleep apnoea due to hypertrophic lymphatic tissue is one of the main reasons for adenotonsillectomies in children. In many hospitals, anesthetists insist on postoperative oxygen monitoring in children with suspicion of OSA in anamnesis. The goal of this study was to evaluate the influence of OSA in children on perioperative and postoperative complications.

Methods:

The medical charts of 2000 children who underwent adenotonsillectomies at our institution between 2009 and 2017 were analyzed retrospectively. In about 25% of those children, OSA was suspected, and they were subsequently monitored postoperatively for 24 hours at our pediatric ward including measurement of saturation and heart rate. The influence of weight, BMI, medical history, duration of surgery and specifically OSA on perioperative and postoperative complications was evaluated.

Results:

As risk factors for perioperative complications were identified: low and very high weight and BMI, younger age, long medical history and OSA, which is in accordance to the literature. During the 24 hours of postoperative monitoring, however, complications only arose for children with OSA additionally suffering from severe syndromal diseases.

Conclusion:

OSA in children only increases the risk for complications during or immediately after anesthesia, but not during postoperative care without additional risk factors like severe syndromal diseases. Adenotonsillectomy is the appropriate therapy for OSA due to lymphatic hypertrophy in children. In our opinion, there is no need for postoperative monitoring with measurement of saturation just because of a suspected OSA.

Publication History

Publication Date:
23 April 2019 (online)