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The investigators aim to assess the respiratory effect of short half-life agents in balanced anesthesia on patients suffering from non-treated or suspected obstructive sleep apnea syndrome (OSA) We will study the impact on OSA of a regimen of remifentanil-desflurane versus a regimen of fentanyl-sevoflurane. Each patient will undergo three respiratory portable polygraphies: the night before the surgery ; the first night following the surgery ; the third night following the surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SEVO-FENTA | Active Comparator | Patients scheduled for lower limb surgery will receive a balanced anesthesia with fentanyl and sevoflurane. |
|
| DES-REMI | Experimental | Patients scheduled for lower limb surgery will receive a balanced anesthesia with remifentanil and desflurane. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fentanyl and sevoflurane | Drug |
| ||
| Remifentanil and desflurane |
| Measure | Description | Time Frame |
|---|---|---|
| Number of apnea and hypopnea events per hour of sleep (Apnea-Hypopnea index) in supine position | postoperative night 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of obstructive apnea events | postoperative night 1 and night 3 | |
| Percentage of time with saturation < 90% | postoperative night 1 and night 3 | |
| Mean oxygen saturation |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Eric Albrecht, PD, MD | Centre Hospitalier Universitaire Vaudois | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHUV (Centre Hospitalier Universitaire Vaudois) | Lausanne | Canton of Vaud | 1011 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38862381 | Derived | Albrecht E, Wegrzyn J, Rossel JB, Bayon V, Heinzer R. Impact of spinal versus general anaesthesia on perioperative obstructive sleep apnoea severity in patients undergoing hip arthroplasty: a post hoc analysis of two randomised controlled trials. Br J Anaesth. 2024 Aug;133(2):416-423. doi: 10.1016/j.bja.2024.04.051. Epub 2024 Jun 10. |
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| ID | Term |
|---|---|
| D012891 | Sleep Apnea Syndromes |
| D020181 | Sleep Apnea, Obstructive |
| ID | Term |
|---|---|
| D001049 | Apnea |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D020919 | Sleep Disorders, Intrinsic |
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| ID | Term |
|---|---|
| D005283 | Fentanyl |
| D000077149 | Sevoflurane |
| D000077208 | Remifentanil |
| D000077335 | Desflurane |
| ID | Term |
|---|---|
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D008738 | Methyl Ethers |
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|
| postoperative night 1 and night 3 |
| Total sleep duration | postoperative night 1 and night 3 |
| Percentage of time in supine position | postoperative night 1 and night 3 |
| Number of apnea and hypopnea events per hour of sleep (Apnea-Hypopnea index) in supine position | postoperative night 1 and night 3 |
| Mean amplitude of desaturation (AD%) | postoperative night 1 and night 3 |
| Percentage of time in obstructive apnea | postoperative night 1 and night 3 |
| Percentage of time in central apnea | postoperative night 1 and night 3 |
| Percentage of time in mixt apnea | postoperative night 1 and night 3 |
| Sleep Apnea screening questionnaire (STOP BANG questionnaire) | 24h before surgery |
| Sleep Apnea screening questionnaire (Berlin questionnaire) | 24h before surgery |
| Sleep Apnea screening questionnaire (Epworth questionnaire) | 24h before surgery |
| Sleep Apnea screening questionnaire (NOSAS questionnaire) | 24h before surgery |
| Pain scores (numeric rating scale, 0-10) | postoperative day 0,1,2 and 3 |
| Postoperative nausea and vomiting (yes/no) | postoperative day 0,1,2 and 3 |
| Pruritus (yes/no) | postoperative day 0,1,2 and 3 |
| Opiate consumption (mg morphine) | postoperative day 0,1,2 and 3 |
| Level of satisfaction (visual analog scale) | postoperative day 3 |
| D020920 |
| Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
| D004987 |
| Ethers |
| D009930 | Organic Chemicals |
| D006845 | Hydrocarbons, Fluorinated |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D011422 | Propionates |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D005019 | Ethyl Ethers |