Before Surgery, Identify Sleep-Related Breathing Disorders in Kids
For kids going into surgery, if you suspect a sleep-related disorder, then you should consider a sleep-disorder screening questionnaire. The latest AANA (American Association of Nurse Anesthetists) Journal mentions how anesthesia professionals can identify children with sleep-disordered breathing (SDB) before undergoing a general anesthetic.
According to the article (2015) “Snoring, Trouble Breathing, Un-Refreshed (STBUR) Screening Questionnaire to Reduce Perioperative Respiratory Adverse Events in Pediatric Surgical Patients: A Quality Improvement Project,” one of the main challenges of addressing SDB in children is similar to the one for adults: That is, there is a lack of awareness of the risks involved with this condition before having surgery.
Leading the report, Karrey L. Terry, CRNA, DNP, says, “Parents are often unaware of the potential problems related to their child’s snoring. Recognition of this condition is of utmost importance, as children have died after routine tonsillectomies after receiving too much pain medication.”
Anesthesia professionals are in a unique position to uncover SDB because it becomes more evident how patients breathe before going under. In addition to these professionals having knowledge of a patient’s breathing patterns, Certified Registered Nurse Anesthetists (CRNAs) are in a perfect position to reveal undiagnosed SDB prior to surgery. For both professionals, it is essential for them to head off any breathing complications during anesthesia.
One possible complication has to do with general anesthesia suppressing the upper airway muscle activity, which may impair breathing by allowing the airway to close. Anesthesia thus may decrease arterial oxygen saturation.
The STBUR questionnaire provides 5 questions in order to identify SDB prior to surgery. It is vital that the anesthesiologist identify any “at risk” children of this condition because of possible complications. According to the article, the likelihood of developing a perioperative respiratory adverse event (PRAE) increases three-fold when 3 STBUR symptoms are present, and 10-fold when all 5 symptoms are present.
Therefore it is crucial to include the STBUR questionnaire in the pre-anesthesia interview in order to detect a sleep-related disorder. This serves to raise awareness of potential risks, and allows anesthesia professionals to modify their airway passage and anesthesia plans toward safer practices.