PHILADELPHIA, PA — A recent study conducted at the Hospital for Special Surgery (HSS) has revealed significant benefits of using continuous positive airway pressure (CPAP) therapy for patients with obstructive sleep apnea (OSA) undergoing total hip and knee replacement surgeries. The research, presented at the Society of Anesthesia and Sleep Medicine’s 14th annual meeting, demonstrates that pre-surgical use of CPAP can significantly reduce post-operative complications, bringing emergency department visit rates for OSA patients in line with those without the condition.
Obstructive sleep apnea, affecting approximately 40 million adults in the U.S., has been linked to increased surgical complication risks. According to Stavros Memtsoudis, MD, PhD, Anesthesiologist-in-Chief at HSS, “Guidelines on the perioperative management of OSA patients are backed by limited evidence.” The study sought to address this gap by analyzing data from over 100,000 outpatient hip and knee replacement cases performed from 2018 to 2022. It compared outcomes for three groups: OSA patients using CPAP, OSA patients not using CPAP, and non-OSA patients.
Findings indicate that OSA patients who adhered to CPAP therapy before surgery experienced fewer emergency department visits within a day of discharge, similar to those without OSA. Jashvant Poeran, MD, PhD, Director of Research at HSS, noted the study’s importance, stating, “These findings are significant as they support the notion that adhering to these guidelines can benefit OSA patients undergoing surgery.”
The study underscores the importance of preoperative CPAP therapy, encouraging both patients and clinicians to consider its use to mitigate surgical risks. Dr. Poeran emphasized the need for ongoing conversations between patients and physicians about risk-reduction strategies, including the initiation of CPAP therapy pre-surgery.
Looking ahead, the researchers suggest further studies to validate these findings in other surgical contexts and among subgroups with additional risk factors, such as obesity or chronic conditions. There is also a call for more robust preoperative screening and enhanced monitoring, especially as more surgeries move to outpatient settings with limited post-operative observation.
This research marks a significant step forward in improving surgical outcomes for patients with OSA, potentially influencing future care standards by emphasizing the identification and management of sleep apnea in the surgical planning process.
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