Conducta perioperatoria en paciente con apnea obstructiva del sue？o: A propósito de un caso

introduction: despite the high frequency of the obstructive sleep apnea-hypopnea syndrome and of its perioperative severe complications, the risk of these patients is underestimated. clinical case: man aged 54, candidate to incisional herniorrhaphy with a history of sleep obstructive apnea and treatment with nasal continuous positive airway pressure six points in epworth’s somnolence scale, obese, smoker, frequent consumer of alcohol and dyslipemic; clinical elements of possible difficult airway. the assessment scale of perioperative risk in sahos patients was of 8 points (high risk). balanced general anesthesia was administered (fentanyl, halothane, atracurio) and multimodal analgesia” morphine and bupivacaine by epidural catheter, i.v. nolotil and diclofenac. surgical time 150 min. patient was extubated and placed in nasal cpap during the immediate postoperative time. he was transferred to intensive care unit for 24 hrs. postoperative analgesia was satisfactory without complications; the hospital discharge was at sixth day postoperative. development: selecting the anesthetic method are some factors influencing in decision and not much evidences supporting the superiority of one regarding the others. the experience of the anesthesiologist, the type and location of surgical intervention, severity of sahos and availability of resources to care this type of patient over the perioperative time are key for choice. consultation of performance protocols in patients presenting with shaos allowed to prevent its potential risks for surgery and to select the anesthetic plan, which adapted to our conditions avoided possible complications.