• incidence of difficult intubation (3):
• the incidence of difficult intubation was 27.6% for patients with an AHI of > 70
• the incidence of difficult intubation was 19.3% for patients with an AHI from 40 to 70
• the incidence of difficult intubation was the same for OSAS patients with an AHI of < 40 as in the control group.
• risk factors for OSAS (2):

  Symptome und klinische Zeichen der obstruktiven Schlafapnoe

  Symptome und klinische Ze... obstruktiven Schlafapnoe
  Other risk factors: pregnancy, and other skeletal, cartilaginous, or soft tissue abnormalities causing upper airway obstruction (1).

Treatment:

• Zurückhaltende Prämedikation (2)
• For superficial procedures, one should consider the use of local anesthesia or peripheral nerve blocks, with or without moderate sedation.
• If moderate sedation is used, ventilation should be continuously monitored by capnography or another automated method if feasible because of the increased risk of undetected airway obstruction in these patients.
• One should consider administering CPAP or using an oral appliance during sedation to patients previously treated with these modalities (1).
  
• General anesthesia with a secure airway is preferable to deep sedation without a secure airway, particularly for procedures that may mechanically compromise the airway.
• When possible, extubation and recovery should be carried out in the lateral, semiupright, or other nonsupine position.
• Unless there is a medical or surgical contraindication, patients at increased perioperative risk from OSA should be extubated while awake.
• Major conduction anesthesia (spinal/epidural) should be considered for peripheral procedures.
• Für die postoperative Behandlung siehe die entsprechende Rubrik in "pacu".

• Patients that should be hospitalized after surgery (1):
• (superficial surgery in general anesthesia)
• airway surgery
• (minor orthopedic surgery in general anesthesia)
• (gynecologic laparoscopy)
• laparoscopic surgery of the upper abdomen
• Exacerbation of respiratory depression may occur on the third or fourth postoperative day as sleep patterns are reestablished and “REM rebound” occurs (1).
• A patient who has had corrective airway surgery (e.g., uvulopalatopharyngoplasty, surgical mandibular advancement) should be assumed to remain at risk for OSA complications unless a normal sleep study has been obtained and symptoms have not returned (1).

1. Practice guidelines for the perioperative management of patients with obstructive sleep apnea. Anesthesiology. 2006;104:1081- 1093: full text | pdf.
2. Postoperative Betreuung von PatientInnen mit OSAS. KSA: periop
3. Preoperative predictors of difficult intubation in patients with obstructive sleep apnea syndrome. Can J Anesth. 2006;53:393-397: pdf.