A patient has returned from back surgery. The family has brought in the patient's continuous positive airway pressure (CPAP) machine. What is the best rationale for allowing the patient to use the CPAP machine at night?
a. It will keep the patient in deep levels of REM, which will decrease the need for pain medication.
b. It will help decrease hospital noise that will keep the patient awake.
c. The patient needs ventilator support owing to the increased chance of postoperative respiratory complications.
d. The patient needs to follow the same bedtime routine to promote a safe environment for sleep.
C
These patients need ventilator support in the postoperative period because obstructive sleep apnea is linked to increased postoperative respiratory complications. After surgery the patient achieves very deep levels of REM sleep that lead to muscle relaxation and airway obstruction. In these patients the anesthesia in combination with pain medications used after surgery reduces the patient's defenses against airway obstruction. Make sure that patients use their home CPAP equipment. Use pain medication carefully in these patients. Promoting the home bedtime routine is beneficial, but that is not the primary reason for using the CPAP; it is to prevent complications from surgery.
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