رجل عمره ٥٠ سنة، وزنه ١٣٠ كغ، يشخر بشدة وزوجته لاحظت توقف تنفسه أثناء النوم، والفحص أكد انقطاع نفس نومي لكنه غير معالج. سيُجرى له استئصال مرارة بالمنظار. ما الأهم بعد العملية؟

A 50-year-old man weighing 130 kg snores loudly and his wife has noticed pauses in his breathing; testing confirmed untreated sleep apnoea. He is to undergo laparoscopic cholecystectomy. What matters most after surgery?

1. Continuous oximetry and caution with opioids and sedatives
2. Keeping him flat on his back
3. Giving a higher morphine dose because he is obese
4. Stopping his CPAP until discharge

Answer: A) Continuous oximetry and caution with opioids and sedatives. OSA clients are prone to obstruction and hypoxaemia after surgery, especially with opioids and sedatives. Monitor saturation, use their CPAP, elevate the head of the bed and favour opioid-sparing analgesia.