A leading anesthesiologist is fighting against new safety guidelines published by the American Society of Anesthesiologists (ASA), because, he says, they actually put sleep apnea sufferers at risk, and could lead to unnecessary deaths.
Managing Perioperative Risk
Sleep apnea puts sufferers at risk for negative consequences during or after the use of anesthesia, analgesia, or sedation. It significantly increases the risk that people will experience depressed respiration, leading to oxygen shortage, brain damage, or even death.
In order to reduce the risks, the ASA has published guidelines for its members about when to monitor patients after a surgical procedure. The guidelines code different risks according to numerical values. These include the severity of the sleep apnea, the invasiveness of the procedure, and the use of opiates for pain after surgery. If patients reach a certain score, the guidelines say, they should be monitored for potential complications.
But Dr. Kenneth P. Rothfield, Chairman of the Department of Anesthesiology at Saint Agnes Hospital in Baltimore, claims these guidelines could do more harm than good because the numerical coding doesn’t really have any basis in science. He says that these numbers could give anesthesiologists and nurses the impression that some patients may not be at risk when they actually are.
He says that trying to separate patients by their level of risk–risk stratification–without good science puts people at risk. He quotes the Anesthesia Patient Safety Foundation, “risk stratification for increased postoperative electronic monitoring would potentially miss a large population of patients that is at increased risk for opioid-induced respiratory depression.” Instead of trying to figure out which patients should be monitored, he said, hospitals and surgical centers need to monitor all patients with sleep apnea after a procedure. At least until good scientific data can be used to determine the actual levels of risk.
Make Sure Your Surgical Team Knows about Sleep Apnea
Remember to make sure healthcare personnel know about your sleep apnea if you’re undergoing any procedure that involves pain medications, sedation, or anesthesia. This includes minor procedures, such as sedation for dental anxiety.
You also need to make sure you get checked for sleep apnea if you have sleep apnea symptoms, and get a sleep apnea treatment that you can stick with, such as a CPAP alternative, if necessary.. If you need help for your sleep apnea, please call (303) 691-0267 for an appointment with a Denver sleep dentist at the TMJ Therapy & Sleep Center of Colorado.
