Factors associated with postoperative exacerbation of sleep-disordered breathing.

Abstract:

INTRODUCTION:The knowledge on the mechanism of the postoperative exacerbation of sleep-disordered breathing may direct the perioperative management of patients with obstructive sleep apnea. The objective of this study is to investigate the factors associated with postoperative severity of sleep-disordered breathing. METHODS:After obtaining approvals from Institutional Review Boards, consenting patients underwent portable polysomnography preoperatively, and on postoperative nights 1 and 3 in hospital or at home. The primary outcomes were polysomnography parameters measuring the sleep-disordered breathing. They were treated as repeated measurement variables and analyzed for associated factors by mixed models. RESULTS:Three hundred seventy-six patients, 168 men and 208 women, completed polysomnography on preoperative and postoperative night 1. Age was 59 ± 12 yr (mean ± SD). Preoperative apnea-hypopnea index (AHI) was 12 (4, 26) (median [25th, 75th percentile]) events per hour. Thirty-five patients had minor surgeries, 292 intermediate surgeries, and 49 major surgeries, with 210 general anesthesia and 166 regional anesthesia. The 72-h opioid dose was 55 (14, 85) mg intravenous morphine-equivalent dose. Preoperative AHI, age, and 72-h opioid dose were associated with postoperative AHI. Preoperative central apnea index, male sex, and general anesthesia were associated with postoperative central apnea index. Slow wave sleep percentage was inversely associated with postoperative AHI and central apnea index. CONCLUSIONS:Patients with a higher preoperative AHI were predicted to have a higher postoperative AHI. Preoperative AHI, age, and 72-h opioid dose were positively associated with postoperative AHI. Preoperative central apnea, male sex, and general anesthesia were associated with postoperative central apnea index.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Chung F,Liao P,Elsaid H,Shapiro CM,Kang W

doi

10.1097/ALN.0000000000000041

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

299-311

issue

2

eissn

0003-3022

issn

1528-1175

journal_volume

120

pub_type

杂志文章
  • Preanesthetic medication in children: a comparison of oral transmucosal fentanyl citrate versus placebo.

    abstract::Initial studies have suggested that oral transmucosal fentanyl citrate (OTFC) in a dose of 15-20 micrograms/kg may be a safe and effective preanesthetic medication in children and adults, but this has not been demonstrated in a randomized, double-blind fashion. The purpose of this study was to determine in a randomize...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Feld LH,Champeau MW,van Steennis CA,Scott JC

    更新日期:1989-09-01 00:00:00

  • Propofol: relation between brain concentrations, electroencephalogram, middle cerebral artery blood flow velocity, and cerebral oxygen extraction during induction of anesthesia.

    abstract:BACKGROUND:The potential benefit of propofol dose regimens that use physiologic pharmacokinetic modeling to target the brain has been demonstrated in animals, but no data are available on the rate of propofol distribution to the brain in humans. This study measured the brain uptake of propofol in humans and the simulta...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-200212000-00006

    authors: Ludbrook GL,Visco E,Lam AM

    更新日期:2002-12-01 00:00:00

  • Altered hemodynamic response to dobutamine in relation to the degree of preoperative beta-adrenoceptor blockade.

    abstract::The relationship between the extent of preoperative beta-adrenoceptor blockade and the hemodynamic properties of dobutamine was investigated in patients scheduled for elective myocardial revascularization during isoflurane-nitrous oxide anesthesia. Twenty patients had been treated with beta-adrenoceptor blocking drugs...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198806000-00013

    authors: Tarnow J,Komar K

    更新日期:1988-06-01 00:00:00

  • New ultrathin-walled endotracheal tube with a novel laryngeal seal design. Long-term evaluation in sheep.

    abstract:BACKGROUND:A new endotracheal tube (ETT) was fabricated and tested in sheep. It had no tracheal cuff; airway seal was achieved at the level of the glottis through a no-pressure seal made of "gills"; the laryngeal portion was oval-shaped; and the wall thickness was reduced to 0.2 mm. METHODS:Sheep were tracheally intub...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199601000-00019

    authors: Reali-Forster C,Kolobow T,Giacomini M,Hayashi T,Horiba K,Ferrans VJ

    更新日期:1996-01-01 00:00:00

  • Selective anesthesia-induced neuroinflammation in developing mouse brain and cognitive impairment.

    abstract:BACKGROUND:: Recent population studies have suggested that children with multiple exposures to anesthesia and surgery at an early age are at an increased risk of cognitive impairment. The authors therefore have established an animal model with single versus multiple exposures of anesthetic(s) in young versus adult mice...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3182834d77

    authors: Shen X,Dong Y,Xu Z,Wang H,Miao C,Soriano SG,Sun D,Baxter MG,Zhang Y,Xie Z

    更新日期:2013-03-01 00:00:00

  • Etymology of Letheon: Nineteenth-century Linguistic Effervescence.

    abstract::In late 1846, following his successful public demonstrations of surgical anesthesia, Boston dentist William T. G. Morton selected Letheon as the commercial name for the ether-based "preparation" he had used to produce insensibility to pain. We have not identified a first-hand account of the coinage of Letheon. Althoug...

    journal_title:Anesthesiology

    pub_type: 历史文章,杂志文章

    doi:10.1097/ALN.0000000000002969

    authors: Haridas RP,Gionfriddo M,Bause GS

    更新日期:2019-12-01 00:00:00

  • Improvement in oxygenation by phenylephrine and nitric oxide in patients with adult respiratory distress syndrome.

    abstract:BACKGROUND:Inhaled nitric oxide (NO), a selective vasodilator, improves oxygenation in many patients with adult respiratory distress syndrome (ARDS). Vasoconstrictors may also improve oxygenation, possibly by enhancing hypoxic pulmonary vasoconstriction. This study compared the effects of phenylephrine, NO, and their c...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199707000-00004

    authors: Doering EB,Hanson CW 3rd,Reily DJ,Marshall C,Marshall BE

    更新日期:1997-07-01 00:00:00

  • Myocardial hypercarbic acidosis reduces cardiac resuscitability.

    abstract:BACKGROUND:The severity of spontaneous myocardial hypercarbic acidosis during cardiac arrest previously has been predictive of the likelihood of restoring spontaneous circulation. The present study investigated whether hypercarbia itself impairs cardiac resuscitation. Since coronary perfusion pressure is the overriding...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199302000-00019

    authors: Maldonado FA,Weil MH,Tang W,Bisera J,Gazmuri RJ,Johnson B,D'Alessio A

    更新日期:1993-02-01 00:00:00

  • Isoflurane and the pulmonary vascular pressure-flow relation at baseline and during sympathetic alpha- and beta-adrenoreceptor activation in chronically instrumented dogs.

    abstract:BACKGROUND:The extent to which isoflurane anesthesia alters systemic vascular regulation has received considerable attention. In contrast, the pulmonary vascular effects of isoflurane have not been elucidated. Our initial objective was to investigate the net effect of isoflurane on the baseline left pulmonary vascular ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199503000-00014

    authors: Lennon PF,Murray PA

    更新日期:1995-03-01 00:00:00

  • Magnesium chloride and ruthenium red attenuate the antiallodynic effect of intrathecal gabapentin in a rat model of postoperative pain.

    abstract:BACKGROUND:Gabapentin, a gamma-aminobutyric acid analog anticonvulsant, has been shown to possess antinociceptive effects in animal models and clinical trials. An endogenous binding site of [3H]gabapentin has been revealed to be the alpha(2)delta subunit of voltage-dependent Ca2+ channels. Magnesium chloride, ruthenium...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200306000-00026

    authors: Cheng JK,Lai YJ,Chen CC,Cheng CR,Chiou LC

    更新日期:2003-06-01 00:00:00

  • Mechanisms of differential axial blockade in epidural and subarachnoid anesthesia.

    abstract::The mechanisms of persistent differential blocks that accompany subarachnoid and epidural anesthesia are clarified here with the aid of two principles derived from in vitro study of individual myelinated axons: 1) conduction can leap two consecutive blocked nodes but not three, and 2) a fiber length with more than thr...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198905000-00023

    authors: Fink BR

    更新日期:1989-05-01 00:00:00

  • Comparison of enflurane, halothane, and isoflurane for diagnostic and therapeutic procedures in children with malignancies.

    abstract::The authors performed a randomized, prospective trial comparing enflurane, halothane, and isoflurane (each administered with nitrous oxide) to establish which inhaled anesthetic produced the fewest complications and the most rapid induction of anesthesia for children undergoing general anesthesia for diagnostic proced...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-198512000-00015

    authors: Fisher DM,Robinson S,Brett CM,Perin G,Gregory GA

    更新日期:1985-12-01 00:00:00

  • Olprinone, a phosphodiesterase III inhibitor, reduces gut mucosal injury and portal endotoxin level during acute hypoxia in rabbits.

    abstract:BACKGROUND:Preservation of gut integrity has become a therapeutic goal to obviate bacterial translocation in the critically ill. The authors examined whether olprinone, a phosphodiesterase III inhibitor, protected functional and structural integrity of gut mucosa against acute progressive hypoxia. METHODS:Thirty-two a...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200306000-00016

    authors: Satoh T,Morisaki H,Ai K,Kosugi S,Yamamoto M,Serita R,Kotake Y,Takeda J

    更新日期:2003-06-01 00:00:00

  • Antinociceptive effect of low-dose intrathecal neostigmine combined with intrathecal morphine following gynecologic surgery.

    abstract:BACKGROUND:The purpose of this study was to determine whether combination of 1-5 microg intrathecal neostigmine would enhance analgesia from a fixed intrathecal dose of morphine. METHODS:A total of 60 patients undergoing gynecologic surgery were randomized to one of five groups. Patients received 15 mg bupivacaine plu...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200302000-00031

    authors: Almeida RA,Lauretti GR,Mattos AL

    更新日期:2003-02-01 00:00:00

  • Large-dose hydroxyethyl starch 130/0.4 does not increase blood loss and transfusion requirements in coronary artery bypass surgery compared with hydroxyethyl starch 200/0.5 at recommended doses.

    abstract:BACKGROUND:Hydroxyethyl starch (HES) 130/0.4 may impair blood coagulation less than other HES solutions and, thus, may be used at larger doses without increasing the risk of postoperative bleeding. This study tested the hypothesis that volume replacement with 6% HES 130/0.4 at a dose of up to 50 ml/kg does not increase...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200307000-00010

    authors: Kasper SM,Meinert P,Kampe S,Görg C,Geisen C,Mehlhorn U,Diefenbach C

    更新日期:2003-07-01 00:00:00

  • The effects of extracellular magnesium on myoplasmic [Ca2+] in malignant hyperthermia susceptible swine.

    abstract::It is now well established that the pathophysiology of the malignant hyperthermia (MH) syndrome is related to a malfunction of intracellular calcium homeostasis. Magnesium plays important roles in the basic contractile properties of muscle, and many of its actions are antagonistic to those of calcium. The aim of this ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199007000-00016

    authors: Lopez JR,Sanchez V,Lopez I,Ryan JF,Mendoza M,Sreter FA,Allen PD

    更新日期:1990-07-01 00:00:00

  • Nitrogen dioxide production during mechanical ventilation with nitric oxide in adults. Effects of ventilator internal volume, air versus nitrogen dilution, minute ventilation, and inspired oxygen fraction.

    abstract:BACKGROUND:Inhaled nitric oxide (NO) may be useful in the treatment of adult respiratory distress syndrome and other diseases characterized by pulmonary hypertension and hypoxemia. NO is rapidly converted to nitrogen dioxide (NO2) in oxygen (O2) environments. We hypothesized that in patients whose lungs are mechanicall...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199505000-00020

    authors: Nishimura M,Hess D,Kacmarek RM,Ritz R,Hurford WE

    更新日期:1995-05-01 00:00:00

  • Pulmonary shunting during alveolar hypoventilation in the dog.

    abstract::Pulmonary shunting (Qs/Qt) was measured in 16 anesthetized and paralyzed healthy beagle puppies during a control period when the end-expired CO2 concentration was 5 per cent and during alveolar hypoventilation, when the PaCO2 increased to 100 plus or minus 13 torr (mean plus or minus SE) and the ;Ha vecame 7.04 plus o...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197504000-00014

    authors: Stone JG,Sullivan SF

    更新日期:1975-04-01 00:00:00

  • Effects of combining propofol and alfentanil on ventilation, analgesia, sedation, and emesis in human volunteers.

    abstract:BACKGROUND:Propofol and alfentanil frequently are administered together for intravenous sedation. This study investigated pharmacokinetic and pharmacodynamic interactions between propofol and alfentanil, at sedative concentrations, with specific regard to effects on ventilation, analgesia, sedation, and nausea. METHOD...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199601000-00004

    authors: Pavlin DJ,Coda B,Shen DD,Tschanz J,Nguyen Q,Schaffer R,Donaldson G,Jacobson RC,Chapman CR

    更新日期:1996-01-01 00:00:00

  • Reducing myoclonus after etomidate.

    abstract:BACKGROUND:The authors hypothesized that myoclonus after etomidate is dose-related, could be suppressed when small doses of etomidate were administered before induction, and is unassociated with seizure-like activity on electroencephalogram (EEG). METHODS:Three studies were performed. In the first study, 36 men were r...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199901000-00017

    authors: Doenicke AW,Roizen MF,Kugler J,Kroll H,Foss J,Ostwald P

    更新日期:1999-01-01 00:00:00

  • Comparative effects of propofol and halothane on outcome from temporary middle cerebral artery occlusion in the rat.

    abstract::Because propofol has cerebral effects similar to those observed for barbiturates, we postulated that it too might offer protection against a focal cerebral ischemic insult. Spontaneously hypertensive male rats were anesthetized with halothane (in 50% O2/balance N2), and their tracheas were intubated and their lungs me...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199205000-00020

    authors: Ridenour TR,Warner DS,Todd MM,Gionet TX

    更新日期:1992-05-01 00:00:00

  • Isozyme-specific effects of protein kinase C in pain modulation.

    abstract:BACKGROUND:Protein kinase C (PKC) is a family of serine/threonine kinases that contains more than 10 isozymes. Evidence suggests that PKC may play important roles in pain modulation, but the isozyme-specific effects of PKC on different aspects of pain modulation are not fully understood. We hypothesize that different P...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3182390788

    authors: Zhao C,Leitges M,Gereau RW 4th

    更新日期:2011-12-01 00:00:00

  • Opioid-volatile anesthetic synergy: a response surface model with remifentanil and sevoflurane as prototypes.

    abstract:BACKGROUND:Combining a hypnotic and an analgesic to produce sedation, analgesia, and surgical immobility required for clinical anesthesia is more common than administration of a volatile anesthetic alone. The aim of this study was to apply response surface methods to characterize the interactions between remifentanil a...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/00000542-200608000-00009

    authors: Manyam SC,Gupta DK,Johnson KB,White JL,Pace NL,Westenskow DR,Egan TD

    更新日期:2006-08-01 00:00:00

  • Effect of diltiazem on midazolam and alfentanil disposition in patients undergoing coronary artery bypass grafting.

    abstract:BACKGROUND:Midazolam and alfentanil are desirable anesthetic adjuncts for cardiac anesthesia. They are metabolized by cytochrome P450 3A (CYP3A) enzymes. These isozymes are inhibited by concurrent medications, including the calcium channel antagonist diltiazem, which may have an effect on recovery from anesthesia. MET...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199612000-00004

    authors: Ahonen J,Olkkola KT,Salmenperä M,Hynynen M,Neuvonen PJ

    更新日期:1996-12-01 00:00:00

  • Neurologic evaluation of infant and adult rats before and after sciatic nerve blockade.

    abstract:BACKGROUND:Only limited data exist comparing differences in sensory function and responses to neural blockade in infant and adult rats. Therefore, the authors sought (1) to compare baseline thermal, proprioceptive, and postural responses in infant, adolescent, and adult rats; and (2) to compare the effects of sciatic n...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199704000-00026

    authors: Hu D,Hu R,Berde CB

    更新日期:1997-04-01 00:00:00

  • Weak polar interactions confer albumin binding site selectivity for haloether anesthetics.

    abstract:BACKGROUND:Enflurane and isoflurane are structural isomers with different anesthetic potencies and side effects. It is not clear whether these differences are produced by differing occupancy of common protein binding sites or by occupancy of different sites, but the very similar molecular properties make the latter pos...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200504000-00016

    authors: Liu R,Eckenhoff RG

    更新日期:2005-04-01 00:00:00

  • Pulmonary shunt and cardiovascular responses to CPAP during nitroprusside-induced hypotension.

    abstract::The effects of continuous positive airway pressure (CPAP) on cardiovascular dynamics and pulmonary shunt (QS/QT) were investigated in 12 dogs before and during sodium nitroprusside infusion that decreased mean arterial blood pressure 40-50 per cent. Before nitroprusside infusion, 5 cm H2O CPAP significantly, P less th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197705000-00008

    authors: Hodges MR,Stanley TH,Johansen RK

    更新日期:1977-05-01 00:00:00

  • Isoflurane causes "flickering" of the acetylcholine receptor channel: observations using the patch clamp.

    abstract::The authors investigated the effects of a volatile anesthetic (isoflurane) on the functional properties of a well characterized membrane ion channel (the acetylcholine receptor channel), using the patch clamp electrophysiological method together with local microperfusion of isoflurane. They found that isoflurane cause...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198808000-00003

    authors: Brett RS,Dilger JP,Yland KF

    更新日期:1988-08-01 00:00:00

  • Stereoselectivity of bupivacaine in local anesthetic-sensitive ion channels of peripheral nerve.

    abstract:BACKGROUND:The local anesthetic bupivacaine exists in two stereoisomeric forms, R(+)- and S(-)-bupivacaine. Because of its lower cardiac and central nervous system toxicity, attempts were made recently to introduce S(-)-bupivacaine into clinical anesthesia. We investigated stereoselective actions of R(+)-and S(-)-bupiv...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199909000-00031

    authors: Nau C,Vogel W,Hempelmann G,Bräu ME

    更新日期:1999-09-01 00:00:00

  • Neutrophil elastase inhibitor, ONO-5046, modulates acid-induced lung and systemic injury in rabbits.

    abstract:BACKGROUND:Acid instillation leads to direct lung and to secondary systemic organ injury, probably via activated macrophages and neutrophils. This study investigated the effects of neutrophil elastase on organ injury after unilateral lung acid instillation by administrating a specific neutrophil elastase inhibitor, ONO...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199709000-00025

    authors: Kaneko K,Kudoh I,Hattori S,Yamada H,Ohara M,Wiener-Kronish J,Okumura F

    更新日期:1997-09-01 00:00:00