Anesthetic management of patients with transoral robotic surgery for obstructive sleep apnea syndrome
Haydarpasa Numune Training and Research Hospital Medical Journal
The objective of this study was to evaluate patients who underwent transoral robotic surgery (TORS) due to obstructive sleep apnea syndrome (OSAS) with regard to anesthetic management. Methods: A total of 72 patients (20 females and 52 males) were included in this study. Their mean age was 46.94±9.02 years (range: 27-67 years). The Epworth Sleepiness Scale, body mass index (BMI), apnea-hypopnea index, and the neck circumference were calculated for all patients included in the study. These
... study. These patients were evaluated in terms of demographic information, TORS, anesthesia, peroperative findings, and complications. Results: Evaluation of the patients with regard to ASA scores demonstrated that 14 patients (19.4%) were detected as ASA-1, 50 patients (69.4%) as ASA-2, and eight patients (11.2%) as ASA-3. The mean duration of the operations was 131.93±33.67 min (range: 64-210 min). The mean quantity of fluids used throughout the operation was 1.516.94±226.99 ml (range: 1.100-2.200 ml). None of the patients had a history of hemorrhage requiring blood transfusion. None of the patient underwent tracheostomy. All patients were subjected to prolonged intubation and followed up in the intensive care unit for 24 h postoperatively. No statistically significant difference was found between the duration of surgery of the male and female patients and the amount of fluids used during surgery (p=0.264 and p=0.113). It was demonstrated that there was no statistically significant difference between patients with BMI < and >30 kg/m², during the operation (p=0.122). The quantity of fluid used for patients with BMI <30 kg/m² was found to be statistically higher than of those with BMI values of >30 kg/m² (p=0.006). Discussion and Conclusion: OSAS surgery with the TORS method under anesthesia is of utmost importance. We suggest that TORS interventions should be performed in accordance with basic endolaryngeal surgical principles of anesthesia. We are convinced that reports associated with the use of anesthesia experiences related to this subject would increase widespread use of the technique.