Postoperative outcome of patients with narcolepsy. A retrospective analysis

Study Objective: To determine the postoperative outcome of narcolepsy patients, a population that may be at increased risk of perioperative complications, including postoperative hypersomnia, prolonged emergence after general anesthesia, and apnea. Design: Retrospective chart review. Setting: Academic medical center. Measurements: The perioperative outcome of pharmacologically treated narcolepsy patients, diagnosed at the Mayo Clinic sleep laboratory between January 1, 1965, and December 31, 2001, was studied. A total of 37 narcolepsy patients was identified. Charts were reviewed for the following perioperative (intraoperative time plus recovery room time) events: time for extubation, duration of stay in the Postanesthesia Care Unit (PACU), and duration of stay in the hospital. Furthermore, any of the following complications were noted: electrocardiographic (ECG) changes, postoperative nausea and vomiting, hypotension, subjective reports of pain, decreasing oxygen saturation (SpO₂) levels, respiratory complications, postoperative fever, agitation in the PACU, and hypersomnolence in PACU. In addition, patient hospital stay and major morbidity and mortality during hospital stay were recorded. Main Results: Ten patients pharmacologically treated for their narcolepsy symptoms that underwent 27 noncardiac surgical procedures under general anesthesia. We found no evidence that the pharmacologically treated narcolepsy patients were at any increased risk for perioperative complications. Furthermore, their time for endotracheal extubation, length of stay in the PACU and hospital did not differ from nonnarcolepsy patients. Conclusion: Pharmacological therapy for narcolepsy should be continued during the perioperative period. In addition, treated narcolepsy patients are at no increased risk for postoperative complications.