An order-based approach to facilitate postoperative decision-making for patients with sleep apnea

摘要

The clinical practices pertaining to the perioperative management of patients with sleep apnea are inconsistent, and the introduction of a practical approach remains a challenge for a variety of reasons, including diagnostic challenges. In addition, the failure to provide the proper follow-up instructions for patients with suspected sleep apnea may have potential medico-legal ramifications, e.g., if accidents occur while driving or performing occupations wherein safety is critical.In July 2012, the Vancouver Acute Department of Anesthesia (VADA), serving both Vancouver General Hospital (VGH) and the University of British Columbia Hospital (UBCH), introduced a postanesthesia care unit (PACU) order-based sleep apnea protocol (henceforth referred to as "the protocol") in an attempt to address the above-mentioned challenges. The protocol (Figure Panel A) was introduced as an alternative to the established standard three-hour minimum PACU stay for patients with sleep apnea.