Abstract
Polysomnography (PSG) assesses the severity of obstructive sleep apneoa (OSA) and has traditionally been used to predict respiratory complications after adenotonsillectomy. In our centre, availability of a paediatric intensive care bed (PICU) for close post-operative monitoring is mandatory before adenotonsillectomies are performed in children with severe OSA. This has resulted in long waiting lists and cancellation of surgery.
Aim: To determine if PSGs predict post-operative respiratory complications following adenotonsillectomy in children with severe OSA.
Methodology: We performed a retrospective review of 107 children aged three to eighteen years with clinical suspicion of OSA and who underwent an overnight PSG. The PSGs were graded as per the 2007 American Academy of Sleep Medicine guidelines.
Results: Overall, the median AHI was 4 (0 to 164) events/hour and the mean post-operative hospital stay was 2 days (SD=1). Out of 35 children with severe OSA, half had nadir SpO2 of less than 80% and an AHI greater than 24 events/hour. Fifteen of these children underwent surgery and none of them had any post-operative respiratory complications. All of the children recovered well post-operatively and needed no further support upon discharge.
Conclusion: PSGs may not predict post-operative respiratory complications in children with OSA.
- © 2014 ERS
