Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nasal breathing is considered as an important factor in sleep apnea and snoring, and nasal obstruction can lead to an increased respiratory resistance and to inflammatory reactions in the nasal mucosa. Uvulopalatopharyngoplasty is an effective treatment for sleep apnea and snoring. Different operation techniques with minor variations have been introduced during the last few years. Uvulopalatopharyngoplasty with laser technique (LUPPP) has made it possible to perform the operation in local anesthesia. Acoustic rhinometry is a new method for the evaluation of the nasal cavities and the nasopharynx. We measured the volume of nasal cavities and nasopharynx of 29 patients using acoustic rhinometry before and 6 months after the LUPPP operation. There was a tendency to a better nasal patency in the turbinate area, but no change was found in the nasopharyngeal volume. Acoustic rhinometry is a useful tool for measuring the turbinate area, and this part of the nasal cavities seems to be influenced by the LUPPP operation, maybe due to a better ventilation or reduction of the inflammation of the nose. However, technical and methodological improvements are needed before reliable measurements are achieved from the nasopharynx area.
 ...
PMID:The effect of laser-uvulopalatopharyngoplasty on the nasal and nasopharyngeal volume measured with acoustic rhinometry. 928 10

Hecht's syndrome, described in 1969, is a rare autosomal dominant phenotype that includes trismus, pseudocamptodactyly, and somewhat short stature. A 5-year-old white boy with Hecht's syndrome and frequent otitis media, nasal obstruction, and sleep apnea is described to illustrate the otolaryngologic manifestations of this syndrome. Airway management in these patients is complicated by trismus, which does not improve after the induction of anesthesia. Mask anesthesia with spontaneous ventilation has been used successfully in these patients but may be difficult in the majority of otolaryngologic procedures. Blind nasotracheal intubation is an alternative, but in this case it was impossible because of adenoid hypertrophy. In this patient, laryngoscopy and orotracheal intubation were done using a Bullard laryngoscope, and transnasal KTP laser adenoidectomy was done to relieve the obstruction and apnea. The details of Hecht's syndrome and its management are presented in this case review.
 ...
PMID:Airway management in a patient with Hecht's syndrome. 940 14

This study involved subjective evaluation of airway patency, linear measurement of orocraniofacial architecture, and blood pressure measurement in 38 obese sufferers of sleep apnea and 38 matched controls. The study demonstrated that airway management in the sleep apnea group was difficult on both induction and emergence from general anesthesia. Moreover, a smaller, compressed oropharynx was observed in the sleep apnea group. In addition, patients with sleep apnea were characteristically hypertensive. More nursing research is needed to enhance understanding of patients afflicted with sleep apnea and to improve their life quality.
 ...
PMID:Comparative aspects of the airway during general anesthesia in obese sufferers of sleep apnea and matched normals. 944 84

Obstructive sleep apnoea syndrome in children is a complex disorder characterised by repeated nocturnal episodes of increased upper airway resistive load. It is most commonly associated with adenotonsillar hypertrophy and more children are now presenting for adenotonsillectomy. These children may pose different anaesthetic problems to those having surgery for recurrent infection alone and anaesthetic morbidity and mortality has been reported. In addition, due to the varied symptomatology of the condition, children with unrecognised obstructive sleep apnoea syndrome may present for incidental surgery. This is of importance as patients with undiagnosed obstructive sleep apnoea syndrome may experience additional peri-operative morbidity when undergoing incidental surgery. This article aims to review the aetiology, pathophysiology, clinical presentation and anaesthetic management of children with obstructive sleep apnoea syndrome.
Anaesthesia 1998 Jun
PMID:Obstructive sleep apnoea syndrome in children. 970 44

The operation of Laser Assisted Uvulopalatoplasty (LAUP) as described by Kamami is now becoming more commonly used in the treatment of snoring and obstructive sleep apnoea. The authors have treated 95 snoring patients, varying the lengths of the soft palate incisions and percentage of uvula excised. All operations were carried out under general anaesthesia using a CO2 laser. Pilot studies showed incisions that are 25% of the distance between the free edge of the soft palate to the hard palate junction and excision of 50% of the uvula give good results with minimal complications. A further study using these parameters was conducted and postoperative evaluation including polysomnography confirmed this procedure to be effective in reducing snoring levels both subjectively and objectively.
 ...
PMID:Laser Assisted Uvulopalatoplasty: an objective evaluation of the technique and results. 976

A 33-year-old male was scheduled for tonsillectomy and pharyngoplasty due to sleep apnea syndrome. The intubation was uneventful following induction with thiamylal and vecuronium. Anesthesia was maintained with O2-N2O-sevoflurane. No complications were observed during the 90 min operation. After the termination of the anesthesia, a hyperadrenergic state was observed: arterial pressure and heart rate rose to 230/135 mmHg and 135 bpm, respectively. Immediately after extubation, he developed dyspnea with tracheal tag and stridor, and became cyanotic despite the use of a simple oxygen mask and assisted ventilation. Laryngospasm was suspected. The patient was reintubated and suctioned; pink, frothy sputum was not obtained. Arterial blood gases 5 minutes after reintubation revealed a pH of 7.24, Pao2 86 mmHg (FIo2 1.0), and Paco2 54 mmHg. Chest X-ray 30 minutes after reintubation revealed bilateral diffuse alveolar infiltration. The diagnosis was interstitial pulmonary edema. The patient was ventilated mechanically by applying a positive end-expiratory pressure of 5cm H2O, and furosemide and dopamine were administered intravenously. The patient was extubated the next day, and discharged from hospital ten days later. We considered that the lung edema was induced by the severe negative pressure generated by inspirating against a closed upper airway, as well as by the hyperadrenergic state and severe hypoxemia observed during and after extubation.
 ...
PMID:[Pulmonary edema due to acute airway obstruction immediately after tracheal extubation]. 985 97

The pharyngeal airway obstruction during sleep in the obstructive sleep apnea syndrome (OSAS) can be improved after treatment by laser-assisted uvulopalatoplasty (LAUP), a new technique performed under local anesthesia. It permits surgery to be performed without hospitalization or general anesthetic. LAUP has many advantages over the traditional uvulopalatopharyngoplasty (UPPP). It is simple, reliable, hemostatic, sterilizing, and relatively painless. Our experience with LAUP in sleep apnea syndrome is described in 46 patients from December 1988 to May 1993. Among 40 patients classified as successful responders, the respiratory disturbance index (RDI) was reduced more than 50%. Among the 46 patients, in 43.5% of cases (20 patient) there was healing of snoring and sleep apnea syndrome. In 43.5% of cases (20 patients) there was an important reduction of length and number of apneas and a significant improvement in nocturnal oxygen saturation. Thirteen percent (6 patients) were relative failures, with a diminution of snoring, but no reduction in sleep apnea syndrome. There were no important complications reported.
 ...
PMID:Outpatient treatment of sleep apnea syndrome with CO 2 laser, LAUP: laser-assisted UPPP results on 46 patients. 1017 96

A 44-year-old woman who weighed 130 kg (height 158 cm, BMI 52) with a complicated psychiatric history was referred for obesity surgery because of severe sleep apnea, obesity hypoventilation syndrome with frequent pneumonias, arterial hypertension, diabetes mellitus, polyarthralgia and back pain, venous insufficiency, dysmenorrhea, severe heartburn, and incisional hernia. From childhood until 1983, she had undergone 106 operations, mainly for septic/pyemic and intra-abdominal abscesses, 86 of them under general anesthesia. In the 4 years before undergoing bariatric surgery, she had gained 40 kg, nonoperative attempts at weight reduction had failed. Some months before obesity surgery she could fall asleep while standing, and she noticed an entire loss of capacity for work. Respiratory disturbance index measured during sleep by Mesam-4 device was 68 events per hour. Preoperative controlled positive airway pressure (C-PAP) therapy was used. Vital indications for weight reduction were established. Bariatric surgical steps included six operations: (1) vertical banded gastroplasty (VBG); (2) relaparotomy with suspicion of peritonitis, no complications found; (3) hernioplasty simultaneously with panniculectomy; (4) revision and removal of additional flap because of marginal skin necrosis; (5) bilateral thigh dermatolipectomy simultaneously with right-side saphenectomy; and (6) removal of intramammary abscess. Twenty-four months after VBG, she had lost 39 kg (56.5 % EWL) and was doing rather well. Obesity-related diseases except back pain were relieved.
 ...
PMID:Successful bariatric surgery in a patient who underwent more than 100 various operations. 1048 18

The authors report the case of a patient suffering from central sleep apnea (CSA) who underwent neurosurgery for ventriculo-peritoneal derivation under general anesthesia. Given the risk of postoperative hypoventilation in CSA, intraoperative anesthesia was induced using remifentanyl, an opiate with a plasma half-life of less than 5 minutes. Propofol (2 mg/kg) and remifentanyl at a dose of 0.5 microgram/kg was used during induction. The patient was curarised with vecuronium bromide, intubated and ventilated with a mixture of O2/N2O. During the operation, remifentanyl was administered as a continuous infusion at a starting dose of 0.2 microgram/kg/min, subsequently modified according to changes in arterial pressure and heart rate. At the end of surgery, which lasted approximately 120", decurarisation was carried out using prostigmin, and the infusion of remifentanyl was suspended, together with N2O. Reawakening times were recorded. Extubation took place 8' and 30" after the suspension of remifentanyl. Postoperative monitoring of SpO2 continued for 1 h and blood-gas analysis was satisfactory. No hypoventilation episodes were reported throughout the postoperative period and the patient was discharged from hospital after 7 days. The authors consider that remifentanyl should be the drug of choice to guarantee intraoperative analgesia in patients suffering from CSA requiring general anesthesia.
 ...
PMID:[General anesthesia with remifentanil in a case of "sleep apnea syndrome"]. 1052 30

Being overweight increases the risk of developing many common diseases including type-2 diabetes mellitus, hypertension, coronary heart disease, gallstones and various cancers of the gastrointestinal and urogenital tracts. It can also cause or exacerbate osteoarthritis, breathlessness, heartburn, sleep apnoea, venous thromboembolism and psychological distress, particularly anxiety and depression. It makes anaesthesia and surgery more hazardous, and in pregnancy increases the risks associated with childbirth. Being overweight can also complicate day-to-day social functioning such as negotiating seats on public transport or purchasing clothes. In this article, we review the evidence that weight loss is beneficial and how this might be achieved using lifestyle changes, drug therapy, or surgery.
 ...
PMID:Why and how should adults lose weight? 1056 62


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>