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sleep apnoea

My mum needs an urgent operation for gall stones but because of her sleep she is having great difficulty in getting the operation .I am looking for any suggestions that could help her
thank you
1 Responses
612876 tn?1355514495
Hi. If I'm understanding correctly, your mother has severe sleep apnea, and this is causing the surgeon and/or anesthesiologist to have second thoughts about putting her under general anesthesia to have gall bladder surgery? (If I've got that wrong, PLEASE by all means, set me straight!)

Sleep apnea is definitely a major risk factor for anesthesia complications. Other major risk factors include:
-having a family member who has had a bad reaction to anesthesia (for example, a spike in temperature called "malignant hyperthermia" which is triggered by certain types of general anesthesia agents)
-obesity
-not fasting before your procedure (which poses a risk of vomiting and aspiration)
-smoking, alcoholism, other drug abuse
-high blood pressure
-diabetes
-drug allergies
-diseases of the heart, lungs (including asthma or COPD), or kidneys
-taking medications such as aspirin, warfarin, coumadin that thin the blood or lower clotting factors
-old age

Anesthesiologists have to take all of these factors into account (and more!) when deciding whether it's safe to operate on a person, and if so, which medications are safe for making that person comfortable during the operation.

For people in the "high risk" category for anesthesia, such as your mum due to her sleep apnea, it is advisable to have a pre-planning consultation with the anesthesiologist. This is an appointment where you meet in person with either an anesthesiologist or a nurse anesthetist and your complete medical history is reviewed; by the end of this appointment, the nurse or doctor can formulate a plan for anesthesia that is safe and appropriate in your particular case. Has the surgeon suggested such an appointment, or could you mum (or you on her behalf) request one? This would likely help you resolve this issue.

Keep in mind, that surgery can often be performed even if a person cannot safely have general anesthesia; this just requires use of a different protocol. For example, spinal anesthesia might be used, which completely numbs the body from a certain level down but leaves the person conscious. Also, there are anesthetic agents that don't have as much risk of respiratory depression as general anesthetic. I myself am high risk for general anesthesia and had a life-threatening reaction to propofol (a general anesthetic) in the past, and the anesthetic agent I get now is called Precedex. Precedex has much less risk of respiratory depression. Another example of an alternative medication would be ketamine.

Obviously, only the anesthesiologist and surgeon can determine what is right for your mom. I just wanted to reassure you that there are other options available that can be safe, even for people with sleep apnea. Also you need to ask if they want your mum to bring her C-PAP (if she uses one) to the hospital with her the day of the surgery. She may need to wear it either during surgery or in the recovery room.

I hope this works out for your mum,
Let me know if there's any other information I can get for you,
H.
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