Anaesthesia For Children With Obstructive Sleep Apnoea

Abstract

In summary, sleep disordered breathing in children may vary from simple snoring to severe OSA. Severe OSA is due to a variety of causes, the most common of which is adenotonsillar hypertrophy in
young children. Severe OSA results in failure to thrive, behavioural problems, and rarely in the worst cases, pulmonary hypertension with right heart failure. Children with OSA should be anaesthetised
with care; deep anaesthesia should be avoided and they are sensitive to opioids. Those undergoing adenotonsillectomy should be cared for in a monitored environment postoperatively as the obstruction
will not be relieved on the first postoperative night (swelling at the surgical site); and there is the added risk of the effects of residual anaesthesia. A nasopharyngeal prong airway should be considered; it has
revolutionised our care of these patients.