Nursing Care of a Patient with Obstructive Sleep Apnea Undergoing Orthognathic Surgery: A Case Study

Abstract

Introduction: Patients with Obstructive Sleep Apnea (OSA) who undergo orthognathic surgery (Underwent maxillary and mandibular surgery combined with orthodontic treatment) under general anesthesia are at risk for anesthetic complications.

objectives: To propose guidelines for nurse anesthetist care across the preoperative, intraoperative, and postoperative phases under general anesthesia.

Key issues: This case study involved a 53-year-old Thai male diagnosed with OSA who underwent maxillary and mandibular surgery. The nursing process was applied to assess patient problems, plan, implement nursing interventions, and continuously evaluate patient care. Key problems were identified including preoperative anxiety, risk of difficult intubation and intraoperative hypoxia, and risk of postoperative airway obstruction combined with pain. Key nursing interventions included preoperative education and patient preparation, equipment preparation and respiratory monitoring during anesthesia, and postoperative airway management combined with pain assessment.

Conclusions: Nurse anesthetists play a crucial role in patient assessing and risk identification, particularly in patients with comorbidities. This role requires specialized knowledge and skills in airway management, vital sign monitoring, and sedation level maintenance. The findings demonstrate that applying the nursing process together with multidisciplinary care can effectively reduce the risk of complications.

Implications: Evidence-based anesthesia nursing practice guidelines should be developed for patients with OSA undergoing orthognathic surgery under general anesthesia. The guidelines should integrate multidisciplinary care across preoperative risk assessment, intraoperative airway management, and postoperative monitoring with defined safety outcomes such as hypoxemia and airway obstruction to improve care quality and standardize practice.