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 (CPAP machine) | ||
| lines_access = 1 PIV | | lines_access = 1 PIV | ||
| monitors = Standard ASA | | monitors = Standard ASA | ||
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=== Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> === | === Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> === | ||
CPAP machine is placed on patient. As the patient is slowly sedated, an endoscope is inserted into CPAP after the patient is sedated to observe dynamic airway behavior. | |||
== Preoperative management == | == Preoperative management == | ||
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=== 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. --> === | ||
* | * CPAP machine by surgeons | ||
*Propofol ~20 mg bolus | |||
=== 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. --> === | ||
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* Propofol TIVA | * Propofol TIVA | ||
** Initial bolus of 20 | ** Initial bolus of 20 mg | ||
**Start infusion typically around 125 mcg/kg/min | **Start infusion typically around 125 mcg/kg/min | ||
** | ** Give 10 mg every 2 minutes and/or increase infusion by 25 mcg/kg/min | ||
=== 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. --> === | ||
Latest revision as of 14:05, 14 April 2025
Drug-induced sleep endoscopy
| Anesthesia type |
MAC |
|---|---|
| Airway |
Natural airway (CPAP machine) |
| 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
CPAP machine is placed on patient. As the patient is slowly sedated, an endoscope is inserted into CPAP 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
N/A
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
- CPAP machine by surgeons
- Propofol ~20 mg bolus
Positioning
Supine
Maintenance and surgical considerations
- Propofol TIVA
- Initial bolus of 20 mg
- Start infusion typically around 125 mcg/kg/min
- Give 10 mg every 2 minutes and/or increase infusion by 25 mcg/kg/min
Emergence
Postoperative management
Disposition
Typically home
Pain management
Minimal
Potential complications
References
Top contributors: Tony Wang