阻塞性睡眠呼吸暂停课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,CAUSES OF OSA:,OBESITY BMI,35,MICROGNATHIA & RETROGNATHIA,NECK,17,”,(MEN), 16,”,(WOMEN),NASAL OBSTRUCTION,BIG TONSILS/LARGE TONGUE,CAUSES OF OSA:,阻塞性睡眠呼吸暂停课件,1,、,Is there is a history or observation of apnea or snoring with hypopnea (sleep disordered breathing SDB),2,、,Is there a history or observation of arousal from sleep(extremity movement,turning, vocalization,发声, snorting,鼻息声,),3,、,Is there a history or observation of daytime somnolence (easily falls asleep during the quiet times of the day),1、Is there is a history or obs,阻塞性睡眠呼吸暂停课件,Mild(1): obese, snores most of the time they sleep, not observed apnea or arousals, not falls asleep easily daytime.,Severe(3),：,obese morbidly, snore all night, observed apneas & arousals frequently, falls asleep during most of the quiet times during the day.,Moderate,（,2,）：,between these two extremes,Mild(1): obese, snores most of,阻塞性睡眠呼吸暂停课件,I of A/S,：,0,：,superficial surgery + local anesthesia or peripheral nerve block + not sedation,1: superficial surgery + local anesthesia or peripheral nerve block + moderate sedation,2: superficial surgery + general anesthesia,3: major cavitary or airway surgery + general anesthesia,POR: postoperative opioid requirement,No POR, Low Dose Oral POR ,Moderate Dose Oral POR,And a High Dose of POR (0 score 3score),I of A/S：,PERIOPERATIVE MANAGEMENT OF OSA,：,FACILITY,OUTPATIENT & INPATIENT,RISK =4 ANY FACILITY SHOULD HAVE,1 EMERGENCY DIFFICULT AIRWAY EQUIPMENT,2 RESP CARE RX= NEBULIZES,CPAP,VENTILATORS,3 PORTABLE CHEST X-RAY & ECG,4 CLINICAL LAB FOR ABGS,ELECTROLYTES, HGB/HCT,PERIOPERATIVE MANAGEMENT OF OS,阻塞性睡眠呼吸暂停课件,PERIOPERATIVE MANAGEMENT OF OSA PATIENTS:CONSULTANTS AGREEMENTS:,PREOPERATIVE & INTRAOPERATIVE,Preoperative preparation with cpap or bipap improves physical status.,The airway management in general anesthesia,follow ASA Difficult Airway Guideline.,Moderate/deep sedation - -,use CO2 monitoring,General anesthesia + secure airway deep sedation +no airway,Be extubated when fully awake in the upright position & reversal of neuromuscular blockade.,Spinal/Epidural Anesthesia in peripheral surgery GA& /or Opioids,PERIOPERATIVE MANAGEMENT OF OS,阻塞性睡眠呼吸暂停课件,阻塞性睡眠呼吸暂停课件,CPAP or NIPPV should be administered as soon as possible after surgery to patients with OSA who were receiving it preoperatively.,Continuous bedside SpO2 without continuous observation does,not,provide the same level of safety.,CPAP or NIPPV should be admini,阻塞性睡眠呼吸暂停课件,