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Obstructive sleep apnoea peri-operative planning — FRCA Final MCQ

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HardPerioperative MedicineObstructive sleep apnoea peri-operative planningFRCA Final

A 52-year-old woman with severe obstructive sleep apnoea uses CPAP at home and is scheduled for laparoscopic hysterectomy. She has BMI 46, difficult airway predictors and previous postoperative desaturation after morphine. What is the most appropriate anaesthetic technique?

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Correct answer: D — Opioid-sparing general anaesthesia with postoperative CPAP and monitored recovery

Severe OSA requires airway planning, opioid-sparing multimodal analgesia, cautious extubation and postoperative monitoring with resumption of CPAP when appropriate. Long-acting opioids increase ventilatory risk. Day-case discharge is inappropriate given prior desaturation and high BMI without robust criteria. CPAP is usually part of the safety plan rather than something to avoid reflexively.

Reference: Association of Anaesthetists OSA peri-operative guidance; RCoA GPAS perioperative care