Studies Types of surgery Severity of OSA Day case discharge criteria Day case discharge (%) Reported respiratory events
Banuchi (2014) (10) USA n = 40 PS: n = 20 NS + PS: n = 20 AHI: Range 2.6-119
Mild or moderate OSA (ie AHI ≤ 30)
11/40 (27.5%)
DC: none IP: none
Baugh (2013) (6) USA n = 452 NS: n = 232 (218 DC, 14 IP) PS: n = 181 (155 DC, 26 IP) NS + PS: n = 39 (31 DC, 8 IP)
Not reported
Not specified
404/452 (89.4%)
DC: none IP: none
Hathaway (2006) (12) USA n = 110 PS: n = 80 (70 DC, 10 IP) NS + PS: n = 30 (20 DC, 10 IP)
RDI: Average 35; Range 2 – 103
No postoperative desaturations Adequate oral intake No significant post-op nausea
90/110 (82%)
DC: none IP: 3 desaturations (recovery)
Kandasamy (2013) (14) Canada n = 345 PS: n = 310 NS + PS: n = 35 AHI: Mean 32.8; Range 2 - 128
Not specified
97/345 (28%)
DC: 5 (5.2%) desaturations (PACU) IP: 39 (15.7%) desaturations (combination of PACU and ward) 1 laryngospasm
Kieff (2004) (15) USA n = 86
NS + PS: n = 86
RDI: Mean 36.4; Range 13 - 89 Saturations >94% on room air in recovery No known COPD, CAD or diabetes Adequate oral intake or analgesia Stable vital signs
23/86 (26.7%)
DC: none IP: Unclear as did not report proportion of patients who were admitted due to desaturations
Pang (2012) (8) Singapore n = 487 NS + PS: n = 175 NS + PS + tongue surgery: n = 312 AHI: Mean 47.3; Range 21.7 – 85.5 No concurrent tongue surgery Patient preference
150/487 (30.8%)
DC: none IP: 6 desaturations (recovery) 9 (1.8%) tongue swelling 1 upper airway obstruction due to floor of mouth haematoma
*# Rotenberg (2015) (16) Canada n = 50 NS: n = 20 PS: n = 36 Tongue surgery: n = 14 Multilevel surgery: n = 11 AHI: Mean 24.4 +/- 12.2 Able and willing to wear CPAP if planned to do so No witnessed apnoea or desaturations <90% on room air or airway obstruction No complex narcotic analgesia requirements
39/50 (78%)
DC: none IP: 11 desaturations (PACU)
Spiegel (2005) (7) USA n = 117
Mixture of PS only, NS + PS and radiofrequency tongue base reduction - numbers not specified
Not reported
Surgeons preference All radiofrequency tongue base reduction was admitted Incidence of early post-op complications
10/117 (8.5%)
DC: none IP: 3 desaturations (1 in recovery, 2 on ward) 2 laryngospasms
Strocker (2008) (13) USA n = 40 PS: n = 38 NS + PS: n = 2
RDI/AHI: Range 5 – 99
Not specified
36/40 (90%)
DC: none IP: none
# Terris (1998) (11) USA n = 109 NS: n = 16 PS: n = 73 NS + PS: n = 36 RDI: Mean 37.7 +/- 11.8
Not specified
16/125 (12.8%)
DC: none IP: 5 (4.6%) desaturations 1 significant airway compromise requiring naloxone, oxygen and airway suctioning
Nasal surgery (NS); Palatopharyngeal surgery (PS); Day case (DC); Inpatient (IP); Apnoea-Hypopnoea Index (AHI); Respiratory Disturbance Index (RDI); Post-anaesthetic Care Unit (PACU); Coronary Artery Disease (CAD); Chronic Obstructive Pulmonary Disease (COPD) * Prospective observational study # Authors reported more number of procedures than total patients in the study Nasal surgery (NS); Palatopharyngeal surgery (PS); Day case (DC); Inpatient (IP); Apnoea-Hypopnoea Index (AHI); Respiratory Disturbance Index (RDI); Post-anaesthetic Care Unit (PACU); Coronary Artery Disease (CAD); Chronic Obstructive Pulmonary Disease (COPD) * Prospective observational study # Authors reported more number of procedures than total patients in the study Nasal surgery (NS); Palatopharyngeal surgery (PS); Day case (DC); Inpatient (IP); Apnoea-Hypopnoea Index (AHI); Respiratory Disturbance Index (RDI); Post-anaesthetic Care Unit (PACU); Coronary Artery Disease (CAD); Chronic Obstructive Pulmonary Disease (COPD) * Prospective observational study # Authors reported more number of procedures than total patients in the study Nasal surgery (NS); Palatopharyngeal surgery (PS); Day case (DC); Inpatient (IP); Apnoea-Hypopnoea Index (AHI); Respiratory Disturbance Index (RDI); Post-anaesthetic Care Unit (PACU); Coronary Artery Disease (CAD); Chronic Obstructive Pulmonary Disease (COPD) * Prospective observational study # Authors reported more number of procedures than total patients in the study Nasal surgery (NS); Palatopharyngeal surgery (PS); Day case (DC); Inpatient (IP); Apnoea-Hypopnoea Index (AHI); Respiratory Disturbance Index (RDI); Post-anaesthetic Care Unit (PACU); Coronary Artery Disease (CAD); Chronic Obstructive Pulmonary Disease (COPD) * Prospective observational study # Authors reported more number of procedures than total patients in the study Nasal surgery (NS); Palatopharyngeal surgery (PS); Day case (DC); Inpatient (IP); Apnoea-Hypopnoea Index (AHI); Respiratory Disturbance Index (RDI); Post-anaesthetic Care Unit (PACU); Coronary Artery Disease (CAD); Chronic Obstructive Pulmonary Disease (COPD) * Prospective observational study # Authors reported more number of procedures than total patients in the study