Dexmedetomidine versus propofol during drug-induced sleep endoscopy and sedation: a systematic review
Por:
Chang ET, Certal V, Song SA, Zaghi S, Carrasco-Llatas M, Torre C, Capasso R and Camacho M
Publicada:
1 sep 2017
Ahead of Print:
27 ene 2017
Resumen:
Background The purpose of the present study is to review the
international literature, using a systematic review, for studies
comparing propofol and dexmedetomidine for drug-induced sleep endoscopy
(DISE) or sedation in which there is a description of the effect of the
agents on the upper airway and associated variables (e.g., vital signs,
sedation scores).
Methods This is a systematic review through October 4, 2016.
PubMed/MEDLINE and four additional databases were accessed for this
study.
Results Two hundred twenty studies were screened. 79 were downloaded,
and 10 met criteria. The majority of the studies identified
dexmedetomidine as the preferred pharmacologic agent for DISE due to an
overall safer and more stable profile based upon hemodynamic stability.
However, propofol provided greater airway obstruction with oxygen
desaturations. With either agent, the degree of obstruction in the upper
airway lacks some degree of validity as to whether the obstructions
accurately represent natural sleep or are simply a drug induced effect.
Conclusion Dexmedetomidine and propofol have their advantages and
disadvantages during DISE. Generally, dexmedetomidine was preferred and
seemed to provide a more stable profile based upon cardiopulmonary
status. However, propofol has a quicker onset, has a shorter half-life,
and can demonstrate larger degrees of obstruction, which might more
accurately reflect what happens during REM sleep. Additional research is
recommended.
Filiaciones:
Chang ET:
Division of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96859, USA.
Certal V:
Department of Otorhinolaryngology/Sleep Medicine Centre, Hospital CUF, Porto, Portugal
CINTESIS Center for Research in Health Technologies and Information Systems, University of Porto, Porto, Portugal
Song SA:
Division of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96859, USA
Zaghi S:
Department of Otolaryngology-Head and Neck Surgery Division of Sleep Surgery and Medicine, Stanford Hospital and Clinics, Stanford, CA, USA
:
Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario Doctor Peset, 46017, Valencia, Spain
Torre C:
Department of Otolaryngology-Head and Neck Surgery Miller School of Medicine, University of Miami, Miami, FL, USA
Capasso R:
Department of Otolaryngology-Head and Neck Surgery Division of Sleep Surgery and Medicine, Stanford Hospital and Clinics, Stanford, CA, USA
Camacho M:
Department of Otolaryngology-Head and Neck Surgery Division of Sleep Surgery and Medicine, Stanford Hospital and Clinics, Stanford, CA, USA
Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Redwood City, CA, USA
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