The paper should be no more than 3-4 pages double-spaced (page count does not include title or reference page) and should include:
1) an introductory paragraph;
2) a brief paraphrased synopsis of each article and
3) a paragraph that synthesizes and integrates the 3 studies.
Choose 2 of the original research articles used to support the recommendations in the clinical practice guideline and create a table of evidence, two synthesis tables and a narrative synthesis of the evidence.
Obstructive sleep apnea (OSA) is when the upper airway becomes partially or completely blocked during sleep. In the surgical population, the incidence of OSA varies. It is estimated that 70 percent of bariatric surgery patients have it( Nagappa et al., 2019). It can results in daytime hypersomnolence, signs of sleep disturbance which can manifest as aggressive activity in infants, resulting from repetitive awakening from sleep to restore airway patency(ASA, 2014). Patients with obstructive sleep apnea are at high risk of peri-operative airway obstruction and hypoxia. Profound hypoxic injury from apnea during the postoperative period is often misdiagnosed as cardiac arrest due to other reasons. The perioperative period puts patients at high risk of apneic episodes because of drug effects from sedatives, narcotics, general anesthesia, and the consequences of postoperative rapid eye movement sleep changes and postoperative positioning in the hospital bed (ASA, 2014). OSA is a financial burden because it lengthens hospital stays and raises health-care costs. Most OSA patients go undiagnosed and untreated (Nagappa et al., 2017).
The ASA developed updated the current practice guidelines are to enhance perioperative care and decrease the risk of adverse outcomes in patients with suspected or suspected OSA undergoing surgery and receiving anesthesia. An updated analysis of scientific literature and results from surveys of experts and randomly selected ASA participants are among the latest evidence provided. The new information did not necessitate any changes to the recommendations.STOP-BANG is an effective questionnaire to evaluate the risk of OSA in patients and as an anesthesia provider. Preoperative risk stratification, anesthetic control with risk minimization, and adequate postoperative monitoring are all made possible by screening for OSA. These precautions can help to prevent complications after surgery (Nagappa et al.). This systematic review and meta-analysis aimed to see whether the STOP-Bang questionnaire could be used as an OSA screening method to help triage patients referred to sleep clinics in different parts of the world( (Pivetta et al., 2021).
Chosen clinical guideline
Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea: An Updated Report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Obstructive Sleep Apnea
Author and Article Information
Anesthesiology February 2014, Vol. 120, 268286.
https://doi.org/10.1097/ALN.0000000000000053
Other 2 selected articles for synthesis
Use and Performance of the STOP-Bang Questionnaire for Obstructive Sleep Apnea Screening Across Geographic RegionsA Systematic Review and Meta-Analysis
https://doi.org/10.1001/jamanetworkopen.2021.1009
https://pubmed.ncbi.nlm.nih.gov/33683333/
Bianca Pivetta, HBSc1; Lina Chen, BSc1; Mahesh Nagappa, MBBS2; et al
Association of STOP-Bang Questionnaire as a Screening Tool for Sleep Apnea and Postoperative Complications: A Systematic Review and Bayesian Meta-analysis of Prospective and Retrospective Cohort Studies
Nagappa, Mahesh MD*; Patra, Jayadeep PhD; Wong, Jean FRCPC; Subramani, Yamini MD*; Singh, Mandeep FRCPC; Ho, George BSc; Wong, David T. FRCPC; Chung, Frances FRCPC
Author Information
Anesthesia & Analgesia: October 2017 – Volume 125 – Issue 4 – p 1301-1308
doi: 10.1213/ANE.0000000000002344
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