Difference between revisions of "Drug-induced sleep endoscopy"
From WikiAnesthesia
| Line 1: | Line 1: | ||
{{Infobox surgical procedure | {{Infobox surgical procedure | ||
| anesthesia_type = MAC | | anesthesia_type = MAC | ||
| airway = Natural airway | | airway = Natural airway (nasal cannula) | ||
| lines_access = 1 PIV | | lines_access = 1 PIV | ||
| monitors = Standard ASA | | monitors = Standard ASA | ||
| Line 9: | Line 9: | ||
}} | }} | ||
A drug-induced sleep endoscopy (DISE) is performed for patients with obstructive sleep apnea (OSA), whereby a specialist can use an endoscope to view the upper airway as | A drug-induced sleep endoscopy (DISE) is performed for patients with obstructive sleep apnea (OSA), whereby a specialist can use an endoscope to view the upper airway as the patient is put under anesthesia to observe airway obstruction. | ||
== Overview == | == Overview == | ||
| Line 17: | Line 17: | ||
=== Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> === | === Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> === | ||
Endoscope is inserted after the patient is sedated to observe dynamic airway behavior. | |||
== Preoperative management == | == Preoperative management == | ||
| Line 33: | Line 34: | ||
|- | |- | ||
|Cardiovascular | |Cardiovascular | ||
| | |Watch for pulm HTN | ||
|- | |- | ||
|Pulmonary | |Pulmonary | ||
| | |Watch for sequelae of chronic OSA | ||
|- | |- | ||
|Gastrointestinal | |Gastrointestinal | ||
| Line 57: | Line 58: | ||
=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> === | === Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> === | ||
Propofol infusion, propofol boluses, nasal cannula | |||
=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> === | === Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> === | ||
N/A | |||
=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> === | === Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> === | ||
N/A | |||
== Intraoperative management == | == Intraoperative management == | ||
=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> === | === Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> === | ||
Standard ASA monitors | |||
=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> === | === Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> === | ||
* Nasal cannula | |||
=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> === | === Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> === | ||
Supine | |||
=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> === | === Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> === | ||
* Propofol infusion | |||
** Typically start around 125 mcg/kg/min | |||
** Increase by 25 mcg/kg/min every 2-3 minutes | |||
=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> === | === Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> === | ||
Revision as of 07:59, 14 April 2025
Drug-induced sleep endoscopy
| Anesthesia type |
MAC |
|---|---|
| Airway |
Natural airway (nasal cannula) |
| Lines and access |
1 PIV |
| Monitors |
Standard ASA |
| Primary anesthetic considerations | |
| Preoperative |
Patients with OSA usually obese and may have sequelae |
| Intraoperative |
Slowly induce anesthesia as surgeons watch airway collapse on endoscope |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
A drug-induced sleep endoscopy (DISE) is performed for patients with obstructive sleep apnea (OSA), whereby a specialist can use an endoscope to view the upper airway as the patient is put under anesthesia to observe airway obstruction.
Overview
Indications
Obstructive sleep apnea (OSA)
Surgical procedure
Endoscope is inserted after the patient is sedated to observe dynamic airway behavior.
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Airway | |
| Neurologic | |
| Cardiovascular | Watch for pulm HTN |
| Pulmonary | Watch for sequelae of chronic OSA |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
Operating room setup
Propofol infusion, propofol boluses, nasal cannula
Patient preparation and premedication
N/A
Regional and neuraxial techniques
N/A
Intraoperative management
Monitoring and access
Standard ASA monitors
Induction and airway management
- Nasal cannula
Positioning
Supine
Maintenance and surgical considerations
- Propofol infusion
- Typically start around 125 mcg/kg/min
- Increase by 25 mcg/kg/min every 2-3 minutes
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Indications | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
Top contributors: Tony Wang