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OSA Post-Operative CPAP — FRCA Final MCQ

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ModeratePreoperative AssessmentOSA Post-Operative CPAPFRCA Final

A 58-year-old man (ASA III, 100 kg) with obstructive sleep apnoea (AHI 45) is having a laparoscopic cholecystectomy. In the post-anaesthesia care unit, he is snoring with SpO2 88% on 4L O2 via nasal cannulae. He is rousable but immediately falls back to sleep. What is the most appropriate respiratory support?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Continuous positive airway pressure (CPAP) at his home settings

A patient with known severe OSA (AHI 45) who is demonstrating obstructive episodes post-operatively should be commenced on CPAP at their home prescribed settings. CPAP splints the upper airway open, preventing obstruction. If the patient uses CPAP at home, their device should be brought to hospital and used post-operatively. OSA patients should be monitored with continuous pulse oximetry post-operatively. Opioid doses should be minimised and multimodal analgesia maximised.

Reference: AAGBI – 2015 – Perioperative management of the obese surgical patient; RCOA – 2023 – Day surgery and OSA module