 Anaesthesia and sleep apnoea are very dangerous to combine
Added: 10/26/2005 |
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Anaesthesia, loss of sensation, especially the sensation of touch.
Apnoea, cessation of breathing.
Obstructive sleep apnoea is a widely spread condition affecting about 3% of middle aged people. As a rule it is common with men who are snoring. The consequences of the disease may include type 2 diabetes and hypertension that may lead to cardiovascular disease. That is why such things as anaesthesia and sleep apnoea combination is dangerous. As a rule anaesthetists and apnoea sufferers need constant attention.
Anaesthesia can be general (affecting the entire body and usually accompanied by loss of consciousness) or local (affecting limited areas of the body). The condition may be the result of damage to nerves or nerve centres by disease or injury, or it may be intentionally induced by the administration of drugs for the prevention or relief of pain.
Of the few anaesthetic agents known to the ancients, opium and hemp were the most important. Both were taken by ingestion or by burning the drug and inhaling the smoke. Periods of apnoea in which breathing ceases for a few seconds before resuming may occur during sleep. When apnoea alternates with periods of rapid, heavy breathing (hyperapnoea), such cycles are called Cheyne-Stokes respiration; they may be due to lack of oxygen in the brain, accumulation of acid in the blood, increased pressure on the brainstem, or heart failure. Apnoea may be associated with such harmful conditions as irregularities in heartbeat, high blood pressure, and decreased contractile force of the heart muscle. It has also been linked to some cases of sudden infant death syndrome. Anaesthesia and sleep apnoea are very sinister malaises,
that should be carefully controlled.
So, anaesthesia and sleep apnoea together may be rather dangerous because anesthesia may cause airway obstruction in sleep apnoea sufferers if sedative and opiate drugs are employed without caution.
Sleep apnoea sufferes snore during sleep, which may be due to obstruction of the airway (obstructive-sleep apnoea); may also result from some abnormality in the part of the brain that controls respiration (central-sleep apnoea); or may be due to both conditions (mixed-sleep apnoea). Obesity may be a contributing factor; sleep apnoea sufferers are often advised to give up smoking and to reduce, and also to avoid, sedative or hypnotic drug use. Researchers can sometimes trace the cause to damage in areas of the brain involved with respiratory control. In the case of heavy snoring, better positioning in sleep (not lying on one's back) can reduce the risk of apnoea.
Anaesthesia and sleep apnoea together are to be avoided, because a lot of patient suffer from acid reflux which may be caused during anaesthesia induction. It is very important to work out a plan for hard airway management. Modern anaesthesia almost always involves a combination of agents. Before administering the inhalation anaesthetic, the anaesthetist might give intravenously a short-acting barbiturate such as pentobarbital or sodium pentothal (more properly called thiopental sodium or thiopentone), or an anti-anxiety drug such as diazepam, to induce unconsciousness. An opiate analgesic such as meperidine or fentanyl may be used in addition. To allow use of smaller amounts of the inhalation anaesthetic, special muscle-paralysing drugs are given. These include tubocurarine, gallamine, and succinylcholine. The combination of an opiate, a barbiturate, a muscle-paralysing drug, and nitrous oxide is called balanced anaesthesia. Because muscular activity is prevented in all these procedures, the anaesthetist must induce breathing in the patient mechanically. And surgeons should be very attentive while performing an awake intubation under topical upper way anaesthesia. All the staff of the operation should be experienced in treating the patients with obstructive sleep apnoea during the period of operation.
Anaesthesia and sleep apnoea should be taken very seriously. If you are one of sleep apnoea sufferers and you are going to have surgery, you should properly discuss your condition with your doctor and anaesthetist beforehand. Your anaesthetist should properly examine you and the history of your disease. Tests are of paramount importance and should not be neglected because the combination of anaesthesia and sleep apnoea can do serious harm to your health. It can cause various problems with lungs and heart. At the consultation before the surgery your anaesthetist will try to determine the way your airway will function during the operation. The study is important because as usual airways get difficult after the patient is anaesthetized. Especially it is difficult when the patient has obstructive sleep apnoea. The anaesthetist will use the results of this examination while deciding what kind of anaesthesia should be applied for the patient. For example, the doctor may advise you to have local anaesthesia instead of full general one. However, a lot will depend on the kind of the surgery.
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