A foundational skill required of all anesthetists is airway management. With the obesity epidemic in our nation, obstructive sleep apnea (OSA) is becoming more common and presenting challenges to the anesthetist. Predicting which patients are at increased risk for OSA is an important part of the preoperative assessment. In a recent report published in the british J Anaesth, 2012; 108:5: 768-75, Chung F et all evaluated the correlation of the STOP-Bang scale to the occurrence of sleep apnea.
The STOP-BANG evaluation scale is simple to use. It consists of asking the patient yes or no questions regarding the following 8 items:
- Snoring. Do you snore?
- Tired. Are you frequently tired during the day?
- Obstruction. Have you ever been told that you stop breathing when you are asleep?
- Pressure. Do you have high blood pressure
- BMI Is your BMI over 35?
- Age. Are you over age 50?
- Neck Circumference. Is your neck circumference over 40 cm?
- Gender. Are you male? (should be obvious)
If the answer is yes to 3 or more of these questions, the patient is at increased risk for obstructive sleep apnea. The higher the number, the greater the risk. Of interest, a male over 50 starts with a score of 2 regardless of the other risk factors.
Click here to review the on line assessment tool published by thesleepmd.com
Click here to review the article by Chung et al. as presented by the Virginia Assn of Nurse Anesthetists.