Expert: Dr Ian Jackson - please note UK based - 12/16/2010

Question
QUESTION: QUESTION    Hello my son wake's up early hours off the morning, and had a sleep study done his o2 levels was between the high 60's and middle 70's as the result they done anougher sleep study which showed the same. They referred him to the E N T and have said they want to take the tonsils and adenoids out, he will be under General Anesthesia but yet he has never had infected tonsils nor are the large nor are his adenoids. The ENT did say it's a risky operation but when he is under GA his o2 levels will drop, I'm very concered so any help and advice would be grate as i only got seen 2 week's ago and his operation date for the 6th off Jan has come through already. i live in the UK.

many thanks Heidi

ANSWER: Hi there
It sounds like they believe your son has obstructive sleep apnoea. The investigations have shown that he drops the amount of oxygen he carries in his blood stream to very low levels during his sleep. It should remain in the mid to high 90's in a child of five.
During certain periods when he is asleep he is losing the control of the muscles that keep his airway open i.e. the muscles around the area in the back of his throat. The relaxation of these muscles causes the airway to become really small and obstructed. His tonsils and adenoids form part of this area and even if they are small they can be contributing to this problem.
The idea is to take them away and then hopefully his airway will be much bigger and will not obstruct. It is important to monitor children carefully after the operation to make sure their is no problem in the first few nights after the op.
So it sounds like he needs the operation. He should be managed in an appropriate childrens unit and be monitored (oxygen saturations) post op especially for the first night.
I hope this info helps
Kind regards
Dr Ian Jackson

---------- FOLLOW-UP ----------

QUESTION: Thank you very much, but still my may concern is when he is under a ga, and his oxgyen will fall will he be on oxygen while havig a operation to keep the o2 levels up.

many thanks heidi

Answer
During the operation will not be a problem - this is all an issue due to his airway becoming constricted. During the operation he will have a small tube inserted to protect and secure his airway (endotracheal tube) and the anaesthetist will use some extra oxygen. His oxygen levels will therefor be fine. Plus he will be monitord carefully.
Kind regards
Dr Jackson