Clinical Predictors of Apnoea-Hypopnoea During Propofol Sedation in Patients Undergoing Spinal Anaesthesia

This study assessed the relationship between the occurrence of apnoea-hypopnoea during propofol sedation for spinal anaesthesia and two different predictive tests of sleep apnoea: the STOP-Bang score (snoring while sleeping, daytime tiredness, observed breathing stoppages, high blood pressure-body mass index, age, neck circumference, gender); and the obstructive sleep apnoea (OSA) score. Both assessment tools have some predictive value for the occurrence of apnoea-hypopnoea during propofol sedation in patients undergoing spinal anaesthesia.

Obesity Hypoventilation Syndrome: A Review of Epidemiology, Pathophysiology, and Perioperative Considerations

Obesity hypoventilation syndrome (OHS) is defined by the triad of obesity, daytime hypoventilation, and sleep-disordered breathing without an alternative neuromuscular, mechanical, or metabolic cause of hypoventilation. It is a disease entity distinct from simple obesity and obstructive sleep apnea. OHS is often undiagnosed but its prevalence is estimated to be 10–20% in obese patients with obstructive sleep apnea and 0.15–0.3% in the general adult population. Compared with eucapnic obese patients, those with OHS present with severe upper airway obstruction, restrictive chest physiology, blunted central respiratory drive, pulmonary hypertension, and increased mortality.

Active Emergence from Propofol General Anesthesia is Induced by Methylphenidate

In this study, Chemali et al. demonstrate in rats that methylphenidate (Ritalin) not only decreases time to emergence after a single bolus of propofol, but also induces emergence during continuous propofol general anesthesia. These findings suggest that methylphenidate may be a useful arousal-promoting agent for patients oversedated with propofol.