Strategies in postoperative analgesia in the obese obstructive sleep apnea patient

OBJECTIVE: Obstructive sleep apnea (OSA) has become an epidemic worldwide, and OSA patients frequently present for surgery. Comorbidities such as cardiovascular disease, diabetes, hypertension, stroke, gastrointestinal disorder, metabolic syndrome, chronic pain, delirium, and pulmonary disorder increase the perioperative risk for OSA patients. METHODS: This is a narrative review of the impact of sedative and analgesic therapy on the intraoperative and postoperative course of an obese OSA patient. RESULTS: An understanding of postoperative complications related to OSA and drug interactions in the context of opioid and nonopioid selection may benefit pain practitioner and patients equally. CONCLUSIONS: Management of acute postoperative pain in OSA patient remains complex. A comprehensive strategy is needed to reduce the complications and adverse events related to administration of analgesics and anesthetics.