Analgésie postopératoire chez les patients ayant un syndrome d'apnée du sommeil

One over five patients scheduled for surgery may suffer from sleep apnea syndrome (SAS). SAS may be suspected during preoperative consultation in front of clinical symptoms, or after an unexpected difficult intubation or because of several episodes of apnea and/or arterial oxygen desaturation in the postoperative period, and confirmed by polysomnography. Obstructive SAS is the most common feature. The risk of apnea is increased in these patients during the first postoperative week due to sleep disturbances, consequences of certain surgical procedures, and administration of opiates for postoperative analgesia. Postoperative analgesia may indeed favour regional anaesthesia and non opiaes analgesics administration. Opiates are not contra-indicated but required specific and careful monitoring and a global management of patients including positioning (left lateral decubitus or half upright position), oxygen supplementation and the use of CPAP.