Prevalence of obstructive sleep apnea syndrome and predictors of difficult orotracheal intubation

TL;DR

This study found that over half of patients evaluated before surgery showed signs of obstructive sleep apnea, but these signs were not linked to difficulty in intubation.

Contribution

The study reports the prevalence of obstructive sleep apnea in pre-anesthetic patients and evaluates its correlation with airway predictors.

Findings

54.2% of patients had a STOP-BANG score ≥3, indicating potential obstructive sleep apnea.

All bariatric surgery patients had a STOP-BANG score ≥3.

Predictors of difficult ventilation correlated with high STOP-BANG scores, but not predictors of difficult intubation.

Abstract

Obstructive sleep apnea syndrome (OSAS) is an underdiagnosed condition that causes recurrent episodes of partial or total collapse of the upper airways during sleep. It is associated with perioperative pulmonary complications. The STOP-BANG is a screening tool for assessing patients at risk of OSAS. The aim of this study was to assess the prevalence of patients with OSAS during pre-anesthetic evaluation at a hospital and its correlation with predictors of ventilation and difficult airway.

This is an observational, cross-sectional study carried out from January 2022 to September 2023. The questionnaire comprised demographic data (age, weight, BMI, type of surgery, and anesthesia), the STOP-BANG, predictors of difficult orotracheal intubation (Mallampati, mouth opening, thyromental distance, cervical mobility, and upper lip bite test), and predictors of difficult ventilation through a facial mask (male sex, absence of teeth, presence of beard, obesity, and >55 years).

The study had the participation of 221 patients, of whom 121 presented with a STOP-BANG ≥3, with a prevalence of 54.2%. All patients undergoing bariatric surgeries presented STOP-BANG ≥3. No significant statistical relationships were found between predictors of difficult orotracheal intubation and STOP-BANG ≥3. However, significant statistical relationships were found in relation to predictors of difficult ventilation through the facial mask.