IS POSTOPERATIVE INTENSIVE-CARE MONITORING NECESSARY AFTER UVULOPALATOPHARYNGOPLASTY

We conducted a retrospective review of 347 consecutive patients who un derwent surgical treatment for obstructive sleep apnea syndrome. We an alyzed perioperative data to identify the nature and rate of complicat ions in an attempt to determine whether intensive care unit monitoring is needed after uvulopalatopharyngoplasty (UPPP) and associated proce dures including septoplasty, tonsillectomy, turbinate reduction, genio hyoid advancement, and tracheostomy In the 347 cases, 14 complications occurred (4%), including 5 involving the airway, 5 postoperative hemo rrhages, and 4 complications classed as ''other,'' including dehiscenc e of a tracheostomy flap, abdominal ileus, urine retention, and increa sed creatinine concentration. We found no difference between preoperat ive lowest oxygen saturation and oxygen-saturation readings in the pos toperative period and no correlation between complication rate and apn ea severity. An association was detected between multiple simultaneous procedures and the development of complications: 50% of the patients in whom complications developed had undergone nasal procedures along w ith UPPP, compared with only 15% of the patients without complications . Except for one patient, all complications that occurred on the surgi cal ward were treated without transfer to the intensive care unit. Alt hough surgery on the upper airway must be performed with caution in pa tients with sleep apnea, our findings suggest that UPPP is a safe proc edure and that postoperative monitoring in an intensive care setting i s not necessary for most patients.