{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:17:06Z","timestamp":1783516626566,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":153,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Patients with obstructive sleep apnoea face increased risk of peri\u2010operative pulmonary complications and prolonged hospital stay. While post\u2010operative continuous positive airway pressure use has proven to be beneficial, less is known about its peri\u2010operative benefits, particularly in procedural settings where deep sedation without an advanced airway is used, including total knee arthroplasty. This retrospective cohort study compared postoperative respiratory outcomes of patients with diagnosed or suspected obstructive sleep apnoea who received intra\u2010operative nasal continuous positive airway pressure vs. standard oxygen mask during total knee arthroplasty under spinal anaesthesia with deep sedation between January 2020 and December 2023. The primary outcome comprised the incidence of oxygen desaturation in the post\u2010anaesthesia care unit. Exploratory outcomes included failure rate of breathing air trial, time to care completion and respiratory support at post\u2010anaesthesia care unit discharge, postoperative pulmonary complication and 2\u2010week unanticipated hospital re\u2010admission rates. Post hoc multivariate regression and 1:1 propensity score matching analyses were performed; p\u2009&lt;\u20090.05 was considered statistically significant. Among 1516 patients, 386 (25%) patients received nasal continuous positive airway pressure, while 1130 (75%) patients received simple oxygen mask intra\u2010operatively. The nasal continuous positive airway pressure group had a higher body mass index (36.8 versus 36.1, p\u2009=\u20090.04) and a higher rate of pre\u2010existing obstructive sleep apnoea diagnosis (66.8% versus 39.7%, p\u2009&lt;\u20090.001). After propensity score matching, post\u2010anaesthesia care unit oxygen desaturation (4.5% nasal continuous positive airway pressure, 4.2% simple oxygen mask, p\u2009=\u20090.86) and breathing air trial failure rates remained similar. Median (IQR) time to care completion was shorter in the nasal continuous positive airway pressure group [59 (48, 60) versus 60 (47, 66) min, p\u2009=\u20090.005]. Two\u2010week unanticipated hospital re\u2010admission rate was less in the nasal continuous positive airway pressure group (1.3% versus 4.0%, p\u2009=\u20090.023). Intra\u2010operative nasal continuous positive airway pressure was not associated with improved postoperative pulmonary outcomes compared to simple oxygen mask use among a cohort of high\u2010risk patients with obstructive sleep apnoea who underwent total knee arthroplasty under spinal anaesthesia and deep sedation. Randomised trials are needed to comprehensively understand the peri\u2010operative benefits of intra\u2010operative nasal continuous positive airway pressure in the setting of spinal anaesthesia with deep sedation.<\/jats:p>","DOI":"10.1002\/anr3.70068","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T01:53:21Z","timestamp":1780538001000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The effect of exposure to intra\u2010operative nasal positive airway pressure in high\u2010risk obstructive sleep apnoea patients after elective total knee arthroplasty: a single\u2010centre retrospective cohort study"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9667-9294","authenticated-orcid":false,"given":"K.","family":"Rychik","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology University of Connecticut Health  Farmington CT 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