Obstructive sleep apnea (OSA) is prevalent and presents perioperative challenges. There are guidelines regarding perioperative care of OSA, but analgesia management of OSA patients is inconsistent or inadequate. This is a study of the United Kingdom anesthesiologists' postoperative analgesia preferences for OSA patients. Overall, the 1st choice of main analgesia was continuous epidural local anesthetic (LA) without opioid, at 30% rate; P = 0.001. The 2nd choice was continuous epidural LA plus fentanyl, at 21% rate; P = 0.001. The 3rd choice was intrathecal diamorphine, at 19% rate; P = 0.001. The 4th choice was nerve block catheter LA infusion, at 13% rate; P = 0.001. The 5th choice was wound infiltration with LA ± epinephrine, at 8% rate; P = 0.001. The 6th choice was systemic opioid, at 7% rate; P = 0.007. The 7th choice was systemic nonsteroidal anti-inflammatory drugs, at 2% rate; P = 0.001. The hospital setting or anesthesiologists' experience did not significantly impact analgesia choice: P =0.411. This study shows that current practice by anesthesiologists has a preference for regional or opioid-sparing analgesia for OSA patients. This safe approach conforms to guidelines and should be encouraged.
Keywords: Obstructive sleep apnea; opioid-sparing analgesia; perioperative guidelines; postoperative analgesia; regional analgesia.