阻塞性睡眠呼吸暂停综合征的发病率和气管插管困难的预测因素。

Revista da Associacao Medica Brasileira (1992) Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI:10.1590/1806-9282.20240347
Jefferson Thiago Medeiros de Oliveira, Heitor Medeiros, Wallace Andrino
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引用次数: 0

摘要

目的:阻塞性睡眠呼吸暂停综合征(OSAS阻塞性睡眠呼吸暂停综合征(OSAS)是一种诊断不足的疾病,会导致睡眠时上气道部分或全部塌陷的反复发作。它与围手术期肺部并发症有关。STOP-BANG 是一种筛查工具,用于评估有 OSAS 风险的患者。本研究旨在评估一家医院在麻醉前评估期间 OSAS 患者的患病率及其与通气和困难气道预测因素的相关性:这是一项观察性横断面研究,研究时间为 2022 年 1 月至 2023 年 9 月。问卷内容包括人口统计学数据(年龄、体重、体重指数、手术类型和麻醉)、STOP-BANG、气管插管困难的预测因素(Mallampati、张口度、甲状腺距离、颈椎活动度和上唇咬合试验)以及面罩通气困难的预测因素(男性、无牙齿、有胡须、肥胖和 55 岁以上):共有 221 名患者参与研究,其中 121 人的 STOP-BANG 值≥3,患病率为 54.2%。所有接受减肥手术的患者都出现了 STOP-BANG ≥3。气管插管困难的预测因素与 STOP-BANG ≥3 之间没有发现明显的统计学关系。但是,通过面罩通气困难的预测因素之间存在明显的统计学关系。
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Prevalence of obstructive sleep apnea syndrome and predictors of difficult orotracheal intubation.

Objective: 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.

Methods: 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).

Results: 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.

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