2017-18 HSC Section 3 Green Book

Chung F, Liao P, Yegneswaran B, et al. Postoperative changes in sleep-disordered breathing and sleep architecture in patients with obstructive sleep apnea. Anesthesiology . 2014; 120(2):287-298. EBM level 2......................................143-154 Summary : This article examined a cohort of 58 patients (20 without obstructive sleep apnea [OSA], 38 with OSA) in the perioperative setting and then compared polysomnography (PSG) metrics in the pre- and postoperative setting. Overall PSG outcomes were worse in both groups in the postoperative setting. Fouladpour N, Jesudoss R, Bolden N, et al. Perioperative complications in obstructive sleep apnea patients undergoing surgery: a review of the legal literature. Anesth Analg . 2016; 122(1):145-151. EBM level 4.........................................155-161 Summary : This is an interesting article looking at adverse perioperative outcomes in obstructive sleep apnea patients as measured by malpractice suits. The study addresses a concern many providers in the U.S. likely have when making decisions about perioperative obstructive sleep apnea care and one of the driving factors behind current practices that tend to lean towards observation in the hospital setting. Nagappa M, Liao P, Wong J, et al. Validation of the STOP-Bang questionnaire as a screening tool for obstructive sleep apnea among different populations: a systematic review and meta-analysis. PLOS One . 2015; 10(12):e0143697. EBM level 1.................................................................................................................162-182 Summary : The STOP-Bang questionnaire is a validated screening tool for obstructive sleep apnea (OSA). This systematic review and meta-analysis assessed the effectiveness of STOP-Bang for screening patients suspected of having OSA and assessed its accuracy in determining the severity of OSA in the different populations. It found a high performance of the STOP-Bang questionnaire in the sleep clinic and surgical population for screening of OSA, and found that the higher the STOP-Bang score, the greater the probability of moderate-to-severe OSA. B. Management of head and neck hemorrhage Hsueh WD, Hwang PH, Abuzeid WM. Perioperative management of antithrombotic therapy in common otolaryngologic surgical procedures: state of the art review. Otolaryngol Head Neck Surg . 2015; 153(4):493-503. EBM level 5......................183-193 Summary : This study analyzed peer-reviewed literature pertaining to thromboembolic risk among patients undergoing common otolaryngologic procedures. The authors advocate for consideration of three factors when determining perioperative management of antithrombotic therapy: patient risk of thromboembolism, bleeding risk of the surgical procedure, and timing of therapy interruption. Jackson RS, Myhill JA, Padhya TA, et al. The effects of preoperative embolization on carotid body paraganglioma surgery: a systematic review and meta-analysis. Otolaryngol Head Neck Surg . 2015; 153(6):943-950. EBM level 5..........................................194-201 Summary : This study is a literature review evaluating patient outcomes after carotid body tumor resection. Patients undergoing preoperative embolization prior to resection had significantly less blood loss and decreased operative times as compared to patients without preoperative embolization.