Discipline of Otorhinolaryngology, University of São Paulo, São Paulo, Brazil.
Otolaryngol Head Neck Surg. 2010 Feb;142(2):218-24. doi: 10.1016/j.otohns.2009.11.002.
The localization of upper airway obstruction in patients with obstructive sleep apnea (OSA) may optimize treatment. Nasoendoscopy during propofol sedation allows such an evaluation, but the effect of this drug on respiratory patterns and muscle relaxation is unknown. The objective of the present study was to determine through polysomnography whether propofol would change sleep parameters.
Prospective study of subjects submitted to polysomnography under sedation with propofol.
Tertiary referral center.
Fifteen non-obese subjects (4 controls/11 OSA patients) were submitted to two diurnal polysomnograms (90-120 minutes of sleep), with and without the use of propofol. The parameters presence of snoring, apnea-hypopnea index (AHI), oxygen desaturation, and sleep architecture were compared.
The use of propofol did not induce snoring in the control subjects, whereas 100 percent of the OSA patients snored. AHI and mean oxygen saturation (SaO(2)) did not differ significantly between examinations with and without sedation. However, minimum SaO(2) differed significantly (P < 0.05) with sedation, being lower during propofol sedation. Propofol also significantly changed the sleep architecture, with a significant increase in N3 sleep (P < 0.005) and total abolishment of rapid eye movement sleep (P < 0.0005) during propofol sedation.
These preliminary results allow us to infer that sedation with propofol changes sleep architecture but permits respiratory evaluation, because the main respiratory parameters evaluated in OSA are maintained. These preliminary results support the view that nasoendoscopy under propofol sedation is a promising examination for management of this disease.
阻塞性睡眠呼吸暂停（OSA）患者上气道阻塞的定位可能会优化治疗。异丙酚镇静下的鼻内镜检查可进行此类评估，但该药物对呼吸模式和肌肉松弛的影响尚不清楚。本研究的目的是通过多导睡眠图确定异丙酚是否会改变睡眠参数。
镇静下接受异丙酚多导睡眠图检查的受试者前瞻性研究。
三级转诊中心。
15 名非肥胖受试者（4 名对照/11 名 OSA 患者）接受了两次日间多导睡眠图检查（90-120 分钟的睡眠），并使用和不使用异丙酚。比较了存在打鼾、呼吸暂停低通气指数（AHI）、氧减饱和度和睡眠结构等参数。
异丙酚在对照组受试者中不会引起打鼾，而 100%的 OSA 患者打鼾。镇静前后 AHI 和平均血氧饱和度（SaO2）无显著差异。然而，最小 SaO2 差异有统计学意义（P<0.05），镇静时更低。异丙酚还显著改变了睡眠结构，N3 睡眠显著增加（P<0.005），异丙酚镇静期间快速眼动睡眠完全消除（P<0.0005）。
这些初步结果表明，异丙酚镇静会改变睡眠结构，但允许进行呼吸评估，因为在 OSA 中评估的主要呼吸参数保持不变。这些初步结果支持这样一种观点，即在异丙酚镇静下进行鼻内镜检查是治疗这种疾病的一种很有前途的检查方法。
