Otolaryngology Department, Asia Sleep Centre, Paragon, Singapore.
Otolaryngology Department, Clinica Universidad de Navarra, Pamplona, Spain.
Laryngoscope. 2020 Feb;130(2):551-555. doi: 10.1002/lary.27987. Epub 2019 Apr 17.
OBJECTIVES/HYPOTHESIS: Our objective was to determine whether drug-induced sleep apnea (DISE) affects the successfulness of the surgical outcome.
Prospective, seven-country, nonrandomized trial.
There were 326 consecutive obstructive sleep apnea (OSA) patients who had nose, palate, and/or tongue surgery included in the study. DISE was performed in only one group.
There were 170 patients in the DISE group and 156 patients in no-DISE group. The mean preoperative body mass index (BMI) for the DISE group was 27.6 ± 4.6, whereas in the no-DISE group it was 28.1 ± 3.9 (P = .23). The mean preoperative systolic blood pressure (SBP) for the DISE group was 130.4 ± 16.7, whereas in the no-DISE group it was 142.9 ± 15.5 (P < .001). The mean preoperative diastolic blood pressure (DBP) for the DISE group was 81.4 ± 9.7, whereas in the no-DISE group it was 89.1 ± 9.7 (P < .001). The mean preoperative apnea-hypopnea index (AHI) for the DISE group was 32.6 ± 18.8, whereas in the no-DISE group it was 33.7 ± 19.6 (P = .61). The mean postoperative AHI for the DISE group was 15.9 ± 12.6, whereas in the no-DISE group it was 13.2 ± 8.8 (P = .023). The age-, gender-, BMI-adjusted percentage change in AHI for the DISE group was -48.4 ± 31.9, whereas in the no-DISE group it was -59.8 ± 18.6 (P < .001). The age-, gender-, and BMI-adjusted success rate for the DISE group was 66.5%, whereas in the no-DISE group it was 80.8% (P = .004). The age-, gender-, and BMI-adjusted change in SBP for the DISE group was -6.1 ± 8.6, whereas in the no-DISE group it was -13.3 ± 11.1 (P < .001). The age-, gender-, and BMI-adjusted change in DBP in the DISE group was -5.2 ± 12.1, whereas in the no-DISE group it was -12.4 ± 11.7 (P < .001). The mean age- and gender-adjusted change in BMI for the DISE group was -4.6 ± 12.9, whereas in the no-DISE group it was -6.3 ± 18.5 (P = .34). The Cohen effect of BMI on the overall AHI, lowest oxygen saturation, and blood pressure changes was 0.08.
DISE may not significantly affect surgical success in OSA.
2c Laryngoscope, 130:551-555, 2020.
目的/假设：我们的目的是确定药物诱导的睡眠呼吸暂停（DISE）是否会影响手术结果的成功。
前瞻性、七国、非随机试验。
共有 326 例连续的阻塞性睡眠呼吸暂停（OSA）患者纳入本研究，这些患者接受了鼻、腭和/或舌手术。仅在一组中进行 DISE。
DISE 组有 170 例患者，无 DISE 组有 156 例患者。DISE 组的平均术前体重指数（BMI）为 27.6 ± 4.6，而无 DISE 组为 28.1 ± 3.9（P =.23）。DISE 组的平均术前收缩压（SBP）为 130.4 ± 16.7，而无 DISE 组为 142.9 ± 15.5（P <.001）。DISE 组的平均术前舒张压（DBP）为 81.4 ± 9.7，而无 DISE 组为 89.1 ± 9.7（P <.001）。DISE 组的平均术前呼吸暂停低通气指数（AHI）为 32.6 ± 18.8，而无 DISE 组为 33.7 ± 19.6（P =.61）。DISE 组的平均术后 AHI 为 15.9 ± 12.6，而无 DISE 组为 13.2 ± 8.8（P =.023）。DISE 组 AHI 的年龄、性别、BMI 调整后百分比变化为-48.4 ± 31.9，而无 DISE 组为-59.8 ± 18.6（P <.001）。DISE 组的年龄、性别和 BMI 调整后的成功率为 66.5%，而无 DISE 组为 80.8%（P =.004）。DISE 组的 SBP 年龄、性别和 BMI 调整后变化为-6.1 ± 8.6，而无 DISE 组为-13.3 ± 11.1（P <.001）。DISE 组的 DBP 年龄、性别和 BMI 调整后变化为-5.2 ± 12.1，而无 DISE 组为-12.4 ± 11.7（P <.001）。DISE 组的平均年龄和性别调整后 BMI 变化为-4.6 ± 12.9，而无 DISE 组为-6.3 ± 18.5（P =.34）。BMI 对整体 AHI、最低血氧饱和度和血压变化的 Cohen 效应为 0.08。
DISE 可能不会显著影响 OSA 的手术成功率。
2c 喉镜，130：551-555，2020 年。
