The Influence of Obstructive Sleep Apnea on Post-Anesthesia Duration of Monitoring: Informing Policy Recommendations for Best Practice in a Veteran Population
Abstract
**Please note that the full text is embargoed** ABSTRACT: Obstructive sleep apnea (OSA) is a common problem affecting millions of Americans annually.
In fact, between nine and fourteen percent of the entire population is affected by OSA (Diffee,
Beach & Cuellar, 2012). Its impact on post-operative care unit (PACU) patients can necessitate
the need for an extended recovery time. At the Dallas Veterans Affairs North Texas Health Care
System (VANTHCS) hospital, there was no minimum PACU stay time policy specified for OSA
patients. These patients had an increased risk of complications beyond the thirty minute period of
stability (as defined by the general PACU stay-time policy). While there was considerable
evidence available in the literature review that supported the clinical justification of creating a
minimum PACU stay time policy, the specific target population also needed to be considered to
inform a recommended duration of stay policy at the local level. Methods: A descriptive
correlational study design was used to determine whether a difference in PACU stay times
existed among patients with or without a diagnosis of OSA. A retrospective chart review was
performed on both groups at a one-to-one ratio. A modified power analysis was employed to
establish a sample size greater than the number sufficient to make the review statistically
significant (minimum needed n=49, used n=lO0). Results: The ANCOV A test applied in this
study indicated that a difference between the OSA and non-OSA groups is highly significant at p
< .001. PACU stay time for the OSA group is 82.9% higher than that of the non-OSA group.
Thus, the results indicate that the mean PACU stay time for the OSA group is significantly and
substantially longer than that for the non-OSA group. Conclusion/Recommendation: It was
recommended that a policy be created to establish a new minimum PACU duration of monitoring
of sixty minutes for patients with either a known or suspected diagnosis of OSA at the Dallas
Veterans Affairs North Texas Health Care System hospital.