DELAYED EMERGENCE FROM ANESTHESIA ASSOCIATED WITH UNDIAGNOSED CENTRAL SLEEP APNEA SYNDROME
Delayed awakening from anesthesia is often
multifactorial including residual anesthetic
drugs, excessive reaction to narcotics and
sedatives, residual neuromuscular blockade
and duration of surgery. Hypercapnic central
sleep apnea syndrome is often encountered at
central hypoventilation syndromes which may
be secondary to other diseases that cause
respiratory centre dysfunction. In this case, 36
years, which had operated from pontine
cavernomas seven years ago, delayed
awakening and unanticipated respiratory
complications following general anesthesia
after pilonidal sinus surgery was reported. This
disorder may be due to central sleep apnea
syndrome in a patient without previous
diagnosis. He was referred to the sleep
laboratory in aspect of the differential
diagnosis. The patient was diagnosed as central
sleep apnea syndrome and home device for
CPAP was recommended. The patient who had
a history of brainstem surgery should be taken
into consideration for the candidate of central
sleep apnea syndrome, and a meticulous
evaluation should be done before surgery.
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