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Airway Surgery in the Ambulatory Setting

  • Ambulatory Anesthesia (GP Joshi, Section Editor)
  • Published:
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Abstract

Purpose of review

The complexity of patients and procedures being considered for ambulatory surgery is increasing. Patients undergoing surgery for the treatment of obstructive sleep apnea (OSA) were previously monitored post-operatively in the intensive care unit, and now, increasingly, these patients are being managed as ambulatory cases. The purpose of this review is to address the selection of adult patients for ambulatory airway surgery.

Recent findings

Guidelines produced by the American Society of Anesthesiologists do not support airway surgery in OSA patients in the ambulatory setting. Guidelines produced by the Society for Ambulatory Anesthesia cite insufficient evidence to endorse ambulatory OSA surgery. Careful consideration should be given to OSA patients undergoing other airway surgery before accepting them for ambulatory surgery. These considerations include associated medical comorbidities, ability to use CPAP post-operatively, location and extent of surgery, and need for post-operative opioids.

Summary

Airway surgery in patients without OSA, including tonsillectomy, nasal surgery, and dental surgery, has a long history of feasibility in the ambulatory setting. Recently, laryngeal surgery and thyroidectomy are being accepted as day cases. There are currently no published guidelines that advocate either for OSA surgery in the ambulatory setting or other ambulatory airway surgery in patients with OSA.

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Authors and Affiliations

  1. Austin Health, 145 Studley Rd, Heidelberg, VIC, 3084, Australia

    Louise Ellard

  2. Department of Anesthesiology, University of Toronto, Toronto, Canada

    David T. Wong

  3. Department of Anesthesia, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T2S8, Canada

    David T. Wong

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  1. Louise Ellard
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  2. David T. Wong
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Correspondence to David T. Wong.

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Louise Ellard and David T. Wong declare that they have no conflict of interest.

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This article is part of the Topical collection on Ambulatory Anesthesia.

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Ellard, L., Wong, D.T. Airway Surgery in the Ambulatory Setting. Curr Anesthesiol Rep 6, 370–380 (2016). https://doi.org/10.1007/s40140-016-0183-4

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