RELATION BETWEEN RISK FACTORS OF OBSTRUCTIVE SLEEP APNEA AND CRITICAL RESPIRATORY EVENTS AMONG PATIENTS UNDERGOING BRONCHOSCOPY WITH INTRAVENOUS ANESTHESIA AT BACH MAI HOSPITAL

Abstract

Anesthesia for bronchoscopy poses unique challenges for the anesthesiologists. By definition, bronchoscopy is an endoscopic technique to visualize the inside of the airways for diagnostic and therapeutic purposes. This procedure needs specific technical precision because both the anesthesiologist and operator share the same working space, that is, the airway. Advances in technology and instrumentation have made it a much safer procedure1 . Flexible bronchoscopy is usually done by respiratory physicians and is the gold standard for visualising the airway and performing various diagnostic and therapeutic interventions. Rigid bronchoscopy usually requires general anaesthesia while flexible bronchoscopy can be done under sedation supplemented with topical anaesthesia1 . Obstructive sleep apnoea (OSA) is caused by repetitive partial or complete obstruction of the upper airway, characterized by episodes of breathing cessation during sleep, which last 10 or more seconds. From the anaesthesiologist’s standpoint, patients with OSA pose significant problems in the perioperative period, including difficult airways, sensitivity to anaesthetic agents, and postoperative adverse events. OSA has been associated with an increase in postoperative complications , and is an independent risk factor for increased morbidity and mortality. A significant proportion of patients with OSA are undiagnosed before surgery. It is therefore increasingly recognized as a significant perioperative problem2,3 . In Respiratory Centre Bach Mai hospital, we perform both flexible bronchoscopy and rigid bronchoscopy under intravenous and general anaesthesia. Flexible bronchoscopy cases account for above 90% of 2 bronchoscopy so we do this research to find out risk factors and complication of obstructive sleep apnea among patients undergoing bronchoscopy with intravenous anesthesia at Bach Mai Hospital. Our objectives were: 1. To evaluate the characteristics of patients at a risk of having obstructive sleep apnea among patients undergoing bronchoscopy with intravenous anesthesia. 2. Relation between risk factors of obstructive sleep apnoea and critical respiratory events among patients undergoing bronchoscopy with intravenous anaesthesia at Bach Mai hospital.