Postoperative monitoring of esophageal pressure in patients with obstructive sleep apnea-hypopnea syndrome who have undergone tonsillectomy with uvulopalatopharyngoplasty.

OBJECTIVES: To realize better postoperative management in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), we elucidated the need for the postoperative monitoring of esophageal pressure (Pes).

METHODS: A prospective randomized controlled study was performed. Adult patients with OSAHS were divided into 2 groups: those administered autoadjusted continuous positive airway pressure (CPAP) before, on, and after the first postoperative night (CPAP group) and those not administered CPAP before or after the surgery (non-CPAP group). Tonsillectomy with uvulopalatopharyngoplasty (UPPP) under general anesthesia was performed on all of the patients. On the first postoperative night, continuous overnight monitoring of Pes and oxygen saturation level was carried out simultaneously with oxygen supplementation in both groups in the patient's room in the general ward.

RESULTS: The CPAP group showed a significantly improved mean inspiratory maximal end-apneic Pes swing on the first postoperative night as compared with the non-CPAP group, although there was no significant difference in oxygen desaturation index on the first postoperative night between the 2 groups.

CONCLUSIONS: Continuous Pes monitoring and CPAP administration were beneficial in the detection and minimization of respiratory disturbances in patients with OSAHS who underwent tonsillectomy with UPPP under general anesthesia.