AN EVALUATION OF PERIOPERATIVE CARE FOR THE OBSTRUCTIVE SLEEP APNEA PATIENT AT A LEVEL ONE TRAUMA CENTER

Obstructive sleep apnea, (OSA) in the perioperative setting can result in difficult airway management and postoperative complications. It is essential that anesthetic plans are individualized and incorporate a reduction in dosages of benzodiazepines and opioids being administered. Owing to the fact that many patients with OSA are not formally diagnosed, risk identification is crucial to improving perioperative care and can be accomplished with the STOP-BANG questionnaire. The purpose of this scholarly project was to examine current perioperative care practices for benzodiazepine and opioid administration to patients with a high-risk of OSA to aid in formulating future practice recommendations. The PICOT question was: In adult patients ages 40 to 60, who underwent surgical procedures in a level one trauma center, does a STOP-BANG score ≥ 3, compared to STOP-BANG score < 3, result in a reduced dose of benzodiazepines and opioids administered perioperatively during the time period of January 2023 to June 2024?
The project took place at a level one trauma center in a major urban medical center. Data were collected via retrospective chart review. Sample size was 100 patient charts, with 50 patients having a STOP-BANG score ≥ 3 and 50 patients having a STOP-BANG score < 3. Analysis of the data included t-tests, ANOVA, and Pearson r correlations. Results concluded that the STOP-BANG group ≥ 3 received higher doses of benzodiazepines (M=1.88mg) and opioids (M=1230.11mg) than those in STOP -BANG group <3 (M=1.68mg and 1065.09mg), although this difference was not statistically significant. Project recommendations are: a system wide protocol to guide administration of benzodiazepines and opioids in patients scoring ≥ 3 on the STOP-BANG questionnaire, reimplementation of the blue wrist bands from a prior QI project, and a QR code attached to patient charts to provide key facts and anesthetic recommendations in caring for the at-risk OSA patient.