Incidence of difficult airway among adult patients of undiagnosed obstructive sleep apnea who are undergoing elective surgery: a prospective cohort study

Abstract

Introduction: Obstructive sleep apnea (OSA) is a dangerous medical disorder marked by obstruction of the upper airway during sleep that is frequently undiagnosed before surgery. Preoperative identification of suspected OSA patients necessitates appropriate preparation and prevents unfavorable outcomes. The incidence of difficult airway in adult patients with OSA who are undergoing elective surgery is significantly increased. Materials and method: The study population was separated into high and low-risk groups based on STOP-BANG scores of ≥3 and <3, respectively. The rate of occurrence was compared between the study groups. SPSS version 23 was used for statistical analysis. P-values <0.05 are considered significant. To find characteristics that predict problematic airway, researchers used logistic regression. Result: A total of 113 participants was enrolled. Based on STOP-BANG 77 patients and 36 patients were grouped in to low risk OSA and high risk OSA, respectively, the incidence of difficult intubation (DI) was significantly higher (22.2%) in high risk OSA group versus 5.2% in low risk OSA group, relative risk of 4.278 (95% confidence interval: 1.378–13.2). Mask ventilation was significantly more problematic for the high-risk group (P=0.011) (25% against 6.5%). Male sex, neck circumference >40 cm, Mallampati class 3, and 12.5 cm stern mental distance were all linked to DI. Age above 50 years, snoring history, and a neck circumference of >40 cm were all found to be predictors. Conclusion: Patients who scored ≥3 on the STOP-BANG had a significantly higher rate of DI and difficult mask ventilation. As a result, the STOP-BANG questionnaire should be used to screen every adult patient undergoing elective surgery for OSA.