The impact of pediatric obstructive sleep apnea on ambulatory surgery

The purpose of this paper is to review pediatric obstructive sleep apnea syndrome (OSAS) with an emphasis on ambulatory adenotonsillectomy. Difficulties in establishing a diagnosis by clinical criteria alone are discussed. Diagnostic tests to establish a diagnosis of OSAS are discussed. The child with severe obstructive sleep apnea is at increased risk for post-adenotonsillectomy respiratory morbidity. The perioperative management with a focus on the ambulatory candidate is discussed.

The child with OSAS presents a challenge to ambulatory surgery because of the high prevalence of OSAS, difficulty in establishing a diagnosis of OSAS and the increased risk of respiratory morbidity.