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Introduction: Obstructive sleep apnea (OSA) is characterized by episodes of partial or complete upper airway obstruction during sleep. The prevalence of pediatric OSA is 1-5% and is highest among children aged 2-6 years old. Perioperative aggravation of OSA can occur due to; respiratory depression by the anesthetic and opioid analgesics, airway narrowing due to intubation edema, and forced supine position. These children may be at increased risk of serious consequences if discharged too early or prescribed post op opioids. We sought to assess the estimated prevalence of pediatric patients at risk for OSA scheduled to undergo urologic day-surgery.

Methods: A 22 item validated Pediatric Sleep Questionnaire (PSQ) was distributed to the parents of pediatric patients aged 6 months to 18 years scheduled to undergo urologic day-surgery between September 1, 2012 and November 30, 2012. A positive response to 8 or more items on the PSQ is associated with increased risk for having OSA. We computed the estimated prevalence of children at risk for pediatric OSA based on the PSQ results.

Results: Total of 140 patients where analyzed over the 3 month study interval. The average age for patients was 5.3 years. The most common type day-surgery procedures were; circumcision in 54 (38%), orchidopexy in 21 (15%), hypospadias repair in 13 (9.3%), endoscopic subureteric injection in 9 (6.4%) and phalloplasty in 9 (6.4%). Based on PSQ results, 12 patients (8.5%) showed to be at risk for OSA. The average PSQ score for the children at risk was 9.3; eight of the patients scored 8 items, and remaining four scored >8 items on the PSQ.

Conclusions: Our results suggested increased estimated prevalence of children with OSA awaiting urologic day surgery. In order to optimize the perioperative and post-operative care for children at risk for OSA, screening with PSQ prior to day-surgery at the Pediatric Urology clinic could be beneficial for safe management of these children.