The influence of different application patterns on the sedation courses during drug induced sleep endoscopy

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Background The course of sedation during drug induced sleep endoscopy (DISE) depends on the application pattern of the sedative drug. In order to perform a good evaluation of the upper airway a long transitional period between superficial and deep sedation, providing enough time of investigation, needs to be available. Up to now only few data are present on dose dependent drug application during DISE. Methods 60 consecutive patients undergoing DISE were randomly sedated by 1 % Propfol perfusion at 6 different patterns of application: 1.4ml, 1.6ml, 1.8ml, 2.0ml, 2.2ml/kg/BW/h, individual bolus application 1ml each). Depth of sedation was permanently monitored by BiSpectral Index ® (BIS) and the courses of sedation were analyzed. Results The courses of sedation was dependent on the pattern of Propofol application. The time of DISE performance (BIS 90 - BIS 40) was 12 minutes at 1,4ml and was reduced to 7 minutes at 2,2ml. The period which was available for evaluation of the upper airway between superficial sedation (BIS 70) and deep sedation (BIS 40) ranged from 7 minutes (1.4ml) to 3 minutes (2.2ml). Excessive fluctuations of the sedation courses were not observed in any pattern of application. Conclusion When choosing the pattern of Profol application for DISE it should be considered to have enough time for examination. The time period between superficial and deep sedation should be long enough to provide sufficient time to the investigator to observe the collapsibility of the upper airway under different levels of sedation. On base of the presented data 1.8 – 2.0 ml/kg/BW/h 1 % Propofol appears to be an appropriate pattern of application to obtain a time period of 5 minutes for investigation. Poster-PDF A-1365.pdf Publication History Publication Date: 13 May 2021 (online) © . Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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