Sleep study indices and early post-tonsillectomy outcomes

Publication date: Available online 6 July 2018

Source: American Journal of Otolaryngology

Author(s): Daniel C. O'Brien, Yuti Desai, Robert T. Swanson, Uma Parekh, Jane Schubart, Michele M. Carr

Abstract

Objectives

To investigate the relationships between preoperative sleep study findings of children undergoing adenotonsillectomy anesthesia emergence time, recovery room time, and length of stay.

Study design

Retrospective case series with chart review.

Setting

Tertiary care children's hospital.

Subjects and methods

All children aged 1–17 years who had undergone adenotonsillectomy between 2013 and 2016 were included. Apnea-hypopnea index (AHI), central apnea index (CAI), oxygen saturation nadir, and end-tidal carbon dioxide were compared with the in-operating room times, recovery room time, and length of stay.

Results

Three hundred and fourteen patients with a mean age of 6.67 (95% CI 6.25–7.09) years were included. Mean AHI was 9.14 (95% CI 7.33–10.95), mean CI was 0.88 (95% CI 0.50–1.26), mean oxygen saturation nadir was 82.9% (95% CI 81.41–84.32), mean end-tidal carbon dioxide was 50.3 (95% CI 49.39–51.15). Mean emergence time was 16 min (95% CI 15:11–17:13 min), recovery room time was 66 min (95% CI 1:00–1:11 h), and length of stay was 25.7 h (95% CI 21:43–30:00 h).

When controlled for age, gender and BMI, linear regression showed that children with a higher AHI had a significantly longer operating room and operative times (p < 0.001), emergence time (p < 0.001) and length of stay (p = 0.01). CAI was related to shorter total operating room times (p = 0.03). AHI, oxygen saturation nadir, CAI and end-tidal carbon dioxide were not associated with recovery room time.

Conclusion

Preoperative sleep study indices are associated with longer in-operating room times and length of stay, and can be useful in planning operating room and hospital flow.

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