PSG is the gold standard to evaluate patients with suspected OSA in the current practice; however, its use is restricted due to the time commitment, resource availability, and complex results interpretation. Evidence of the performance of several validated screening tools was identified. The studies suggested that all tools showed acceptable diagnostic accuracy in screening pre-surgical patients with suspected OSA, and the 4-item STOP questionnaire is a shorter questionnaire so may be easier to use compared to the others (10-item Berlin questionnaire and 16-item ASA checklist).
According to two clinical practice guidelines, oximetry can be used in patient monitoring after surgery. Opioid analgesics are not recommended to be prescribed to postoperative patients with OSA; non-opioid analgesics such as nonsteroidal anti-inflammatory analgesics are an option for postoperative pain management. One guideline stated that patients with OSA may require a longer hospital or critical care unit stay compared with those undergoing similar procedures but without OSA.
It remains unclear whether the perioperative risks could be reduced by appropriate screening to detect undiagnosed OSA and implementation of a perioperative management plan for patients with OSA. Further well-designed clinical studies would provide more rigorous evidence to fill the gap.