• Jahan Porhomayon, Kay B Leissner, Ali A El-Solh, and Nader D Nader.
• Departments of *Anesthesiology, Division of Critical Care Medicine §Medicine, Division of Pulmonary, Critical Care, and Sleep, Medicine ∥Anesthesiology, Division of Cardiothoracic Anesthesia and Pain Medicine, VA Western New York Healthcare System, Buffalo School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY †Division of Anesthesia and Critical Care Medicine, VA Boston Healthcare System, Boston University School of Medicine, West Roxbury ‡Department of Anesthesiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
• Clin J Pain. 2013 Nov 1; 29 (11): 998-1005.

ObjectiveObstructive sleep apnea (OSA) has become an epidemic worldwide, and OSA patients frequently present for surgery. Comorbidities such as cardiovascular disease, diabetes, hypertension, stroke, gastrointestinal disorder, metabolic syndrome, chronic pain, delirium, and pulmonary disorder increase the perioperative risk for OSA patients.MethodsThis is a narrative review of the impact of sedative and analgesic therapy on the intraoperative and postoperative course of an obese OSA patient.ResultsAn understanding of postoperative complications related to OSA and drug interactions in the context of opioid and nonopioid selection may benefit pain practitioner and patients equally.ConclusionsManagement of acute postoperative pain in OSA patient remains complex. A comprehensive strategy is needed to reduce the complications and adverse events related to administration of analgesics and anesthetics.

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