Perioperative Risk Modification in Patients with Obstructive Sleep Apnea

The aim of this article was to perform a review of the current literature and to identify studies that highlight the key putative mechanisms associated with increased perioperative risk in patients with obstructive sleep apnea (OSA). We categorized these mechanisms on the basis of specific organ systems, such as cardiovascular and pulmonary systems, as well as risk factors pertaining to anesthesia and surgery (for example, mode of anesthesia and severity of surgery), which may also influence perioperative morbidity and mortality. Using evidence-based clinical practice and expert opinion, we have explicitly described various risk modification strategies for these mechanisms associated with OSA that may be beneficial in guiding best clinical practice with good perioperative outcome. We have also provided a summary table illustrating these factors involved, together with their appropriate risk modifiers.