Abstract: Objective To investigate the perioperative management of severe obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Fifty-three patients with severe OSAHS received uvulopalatopharyngoplasty with uvula preservation and radiofrequency tongue base reduction.All the patients were treated with automated continuous positive airway pressure(CPAP)for 3-7 days before operation and atomated antibiotic therapy administered in the oropharynx,with 24 h ECG monitoring postoperatively.Polysomnography were carried out before and 6 months after surgery.Results The preoperative apnea hyponea index(AHI)and lowest SaO2(LSaO2)were 58.4±5.1/h and 0.650±0.059,respectively,which were 15.5±3.2/h and 0.864±0.064 at 6 months after surgery,respectively,showing significant changes after surgery(P<0.01).Dyspnea occurred in 2 cases after operation,intraoperative bleeding in 1 case,primary bleeding in 2 cases and hypertension crisis in 1 case.Conclusion Severe OSAHS patients are subject to great surgical risk.Application of auto-CPAP before operation can significantly improve the patients’ tolerance of surgery and anesthesia,and reduce the surgical risks and preoperative complications.