Surgery for Sleep Apnea, and Anesthesia

The different procedures include: uvulopalatopharyngoplasty, to try to widen the airway by removing tissues in the back of the throat, including the uvula and pharynx.

These procedures are quite invasive, however, and apart from the usual risks of operating there are other risks of adverse side effects.

The biggest risk is that enough scar tissue could form within the throat as a result of the incisions to make the airway narrower than it was prior to the operation, diminishing the airspace in the throat.

Scarring is an individual trait, so it is difficult for a surgeon to predict how much a person might scar.

Some patients have reported the development of severe sleep apnea as a result of damage to their airway caused by pharnygeal (throat) surgery.

Currently, the American Medical Association does not approve of the use of lasers to operate on the pharynx or uvula.

Radiofrequency ablation is a more recent surgical treatment for snoring.

This treatment applies radiofrequency energy and heat (between 77°C to 85°C) to the soft tissue at the back of the throat, such as the soft palate and uvula, causing scarring of the tissue beneath the skin.

After healing, this causes stiffening of the treated area. The procedure takes less than one hour, is usually performed on an outpatient basis, and usually requires several treatment sessions.

Discomfort and pain is usually light. Radiofrequency ablation is often effective in reducing the severity but does not always completely eliminate snoring.

Bipolar radiofrequency ablation, a technique used for coblation tonsillectomy, is also used for treatment.

Surgery for sleep apnea is a viable if drastic option to stop snoring. In a new procedure, researchers find that inserting three matchstick-sized pieces of polyester material in the upper palate is a simple, low cost, and easily tolerated office procedure that provides effective snoring relief. This is known as pillar implants.

Speak to your GP, to refer you to an otolaryngotomy specialist (Ear nose and throat)about these snoring or sleep apnea implants.

Anesthesia and sleep apnea.

Not all anesthesiologists are aware of the problems associated with sleep apnea patients. Contact the anesthesiologist before surgery for sleep apnea, preferably a day or two before.

If this is not possible, most anesthesiology departments will have someone who can advise you about your options and your concerns.

Consulting the anesthesiologist ahead of time gives him a chance to come up with a plan. If this is not possible, tell your surgeon about it. He doesn't want problems either!

An option for anesthesia during any operation is to use regional anesthesia where possible, especially for extremities like arms and legs, and some abdominal procedures.

Some parts of the body mostly below the ribcage can be numbed without giving any centrally acting drugs. The most common ways to give regional anesthesia are the "spinal" or the "epidural". Epidural is quite often used to relieve the pain of labor.

For patients with sleep apnea, this is an conveniently safe and comfortable without affecting the respiratory drive or the musculature of the pharynx. However the sound effects can be unnerving.

Usually the patient goes to the recovery room where he/she is closely monitored for post-surgery problems. Your CPAP machine may be more important once back in the ward.

The post-procedure discomfort is usually treated with narcotics which should be chosen so as not to depress the urge to breathe further, and here the epidural anesthesia may again be considered.

So, be pro-active and raise the issue.

- Talk to your anesthesiologist or surgeon ahead of time. While the final choice of the type of anesthesia will be a team decision between the patient, surgeon and anesthesiologist, and will be based on the circumstances; the patient can have some control over the choice.

- Avoid general anesthesia if you can.

- Avoid the use of narcotics if possible.

- Take your CPAP and prescription to the hospital when you have surgery.

- Have your CPAP inspected by the hospital engineering staff if you anticipate using it.

Surgery for sleep apnea, and anesthesia, are manageable when approached sensibly.

Return from Surgery for Sleep Apnea to Obstructive Sleep Apnea Treatments

Return from Surgery For Sleep Apnea to Sleep Apnea Help Home Page