Prevalence of Obstructive Sleep Apnea Risk according to the STOP-BANG Questionnaire in an Oral Surgery Office-based Anesthesia Patient Population

Abstract

PurposePatients with obstructive sleep apnea (OSA) are at an increased risk for perioperative and postoperative complications after receiving intravenous (IV) sedation or postoperative analgesia. The researchers previously showed that most oral and maxillofacial surgery (OMS) providers do not screen for OSA using a quantifiable method. The purpose of this study was to determine the prevalence of OSA risk in the OMS office-based anesthesia patient population using the snoring, tiredness, observed apnea, high blood pressure, body-mass index, age, neck circumference, and gender (STOP-BANG) questionnaire. Patients and methodsAfter deeming patients (n = 153) suitable for outpatient IV sedation using an existing institutional ambulatory preanesthesia protocol, 2 OMS providers administered the STOP-BANG questionnaire to classify patient risk for OSA. The questionnaire is a concise, validated predictor for OSA risk and consists of 8 yes or no questions. The study was conducted over the course of a 9-month period, from July 2019 to March 2020. ResultsOf the 153 patients, 141 (92.16%) were at a low risk for moderate to severe OSA, 11 (7.19%) were at a moderate risk, and 1 (0.65%) was at a high risk. Overall, 12 (7.84%) patients were shown to be at risk for OSA. The researchers estimate with 95% confidence that between 5.7 and 10% of all OMS office-based anesthesia patients are at risk for OSA. The IV sedation plans for 4 (2.61%) patients were changed after including OSA risk with the existing preanesthesia protocol. Statistical analysis consisted of a 1-sample test of proportions. ConclusionA statistically significant proportion (95% confidence interval, 0.0567 to 0.100) of the OMS office-based anesthesia patient population is at an increased risk for moderate to severe OSA. These results outline the importance of screening for OSA before office-based anesthesia administration. OMS providers can easily use the STOP-BANG questionnaire to assess OSA risk, modify anesthesia management, and improve patient safety.