Postoperative Complications Clinical Trial
Official title:
Application of Capnography Monitoring on the General Care Nursing Unit
The aim of this study is to increase the detection of undiagnosed obstructive sleep apnea (OSA) and secondly to increase the sensitivity for detection of respiratory depression (< 6 breaths per minute) in post operative patients on the general care nursing unit.
Measures: This is an IRB approved prospective trial beginning with randomization in the post
anesthesia care unit (PACU) and continuing for thirty six hours post orthopedic surgical
procedure. The patients are randomized into a capnography or standard of care group and the
percentage of newly identified OSA patients were measured in each group using the criteria
set forth by 2006 American Society of Anesthesiologist practice guideline (Anesthesiology
2006; 104:1081-93).
Background/Changes: Hospital complications are three times higher in patients with
obstructive sleep apnea and the majority of these complications are related to opioid
induced respiratory depression (Mayo Clin Proc Sept 2001:897-905). American Society of
Anesthesiologist 2006 practice guideline for perioperative management of patients with
obstructive sleep apnea (Anesthesiology 2006; 104:1081-93) lists the criteria for
identifying undiagnosed obstructive sleep apnea. One of the risk factors in the guideline
lists apnea (pauses in breathing). Capnography measures apnea episodes and continuously
monitors respiration rate.
As previously described, five percent of the general population has obstructive sleep apnea
(OSA) and the prevalence among patients requiring surgery is 9% (NEJM 1993; 328:1230-1235).
Between 50-80% of OSA individuals are undiagnosed when presenting for surgery.
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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