Critical care nursing quarterly
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Obstructive sleep apnea (OSA) is a complex medical condition that affects not only the airway but also the cardiopulmonary, endocrine, and central nervous systems. Obstructive sleep apnea can usually be identified with a focused history and physical examination and is commonly associated with obese, middle-aged men with hypertension and glucose intolerance. A high index of suspicion for OSA should arise when reports of loud snoring, nighttime arousal, and acid reflux accompanied by a history of stroke, atrial fibrillation, or congestive heart failure are elicited during a perianesthesia evaluation. ⋯ Central axial opioids and continuous intravenous opioid infusions should be avoided while nonopioid and non-centrally acting analgesics are recommended. Careful postoperative monitoring is important to preventing serious morbidity. Early identification of OSA and its comorbidities is key to developing a safe anesthesia and postoperative treatment plan.