OPTIMIZING ANESTHESIA FOR ENT SURGERY IN INDIVIDUALS WITH SLEEP APNEA

Background: Obstructive sleep apnea (OSA) is a frequent comorbidity in patients undergoing ENT surgery, significantly increasing the risk of perioperative complications such as hypoxia, airway obstruction, and cardiovascular instability. Effective anesthesia management is critical to reducing these risks and improving postoperative recovery. Anesthesia type may directly influence respiratory outcomes, pain control, and hospital stay in this vulnerable population. Objective: To evaluate and compare the impact of total intravenous anesthesia (TIVA), inhalational anesthesia, and regional anesthesia on perioperative outcomes in patients with sleep apnea undergoing ENT surgery. Methods: A prospective, observational study was conducted involving 100 patients diagnosed with OSA and scheduled for ENT surgical procedures. Participants were stratified into three anesthesia technique groups: TIVA (n=33), inhalational (n=34), and regional anesthesia (n=33). Perioperative outcomes assessed included the incidence of postoperative respiratory complications, postoperative pain scores (using a standardized 10-point pain scale), and hospital length of stay. Statistical analysis was performed using SPSS v27, and significance was set at p<0.05. Results: Postoperative respiratory complications occurred in 10% of patients in the TIVA group, 25% in the inhalational group, and 30% in the regional group (p=0.01). The average hospital stay was shortest in the TIVA group at 2.5 days, compared to 3.5 days for inhalational and 4.5 days for regional anesthesia (p=0.02). The regional anesthesia group reported the lowest postoperative pain scores (3/10), followed by TIVA (5/10) and inhalational (6/10) groups (p=0.03). Conclusion: TIVA appears to offer advantages in reducing postoperative respiratory complications and shortening hospital stay in OSA patients undergoing ENT surgery, while regional anesthesia provides superior pain control. Personalized anesthesia selection based on patient-specific needs may significantly enhance surgical outcomes.