Department of Otorhinolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Curr Med Sci. 2021 Dec;41(6):1247-1251. doi: 10.1007/s11596-021-2492-1. Epub 2021 Dec 18.
Drug-induced sleep endoscopy (DISE) allows for the evaluation of dynamic airway collapse in patients with obstructive sleep apnea. However, a standardized sedation regimen for DISE is not yet available. This study aimed to investigate the safety profiles and efficacies of dexmedetomidine combined with butorphanol for DISE.
Sixty patients with obstructive sleep apnea scheduled to undergo DISE were randomly divided into Group D and Group DB. All recipients were initially given intravenous butorphanol (1 mg) (Group DB) or saline (Group D). Subsequently, both groups were sedated using a loading dose of 1.0 µg/kg/h of dexmedetomidine. Hemodynamic and respiratory parameters, the time to attain sufficient sedation, wakeup time, and adverse events during DISE were recorded.
Compared with Group D, the time until sufficient sedation and wakeup time in Group DB were significantly reduced. A higher performer satisfaction level was achieved in Group DB. Patients in Group DB showed a higher incidence of bradycardia compared with Group D. However, the bradycardia resolved spontaneously in both groups without any treatment. There was no instance of cough, hypotension, arrhythmia, nausea or vomiting in either group.
Compared to dexmedetomidine alone, a small dose of butorphanol infusion (1 mg) as an adjunct treatment to dexmedetomidine during DISE can reduce the dosage of dexmedetomidine, shorten the time until sufficient sedation and enhance the performer satisfaction level. This synergistic combination could be a promising sedation regimen for DISE in terms of procedural convenience and patient safety.
药物诱导睡眠内镜（DISE）可评估阻塞性睡眠呼吸暂停患者的动态气道塌陷。然而，DISE 尚无标准化的镇静方案。本研究旨在探讨右美托咪定联合布托啡诺用于 DISE 的安全性和疗效。
60 例行 DISE 的阻塞性睡眠呼吸暂停患者被随机分为 D 组和 DB 组。所有患者最初均给予静脉注射布托啡诺（1mg）（DB 组）或生理盐水（D 组）。随后，两组均给予 1.0μg/kg/h 的右美托咪定负荷剂量镇静。记录血流动力学和呼吸参数、达到充分镇静的时间、苏醒时间以及 DISE 期间的不良事件。
与 D 组相比，DB 组达到充分镇静的时间和苏醒时间明显缩短。DB 组的患者满意度更高。与 D 组相比，DB 组的心动过缓发生率更高。然而，两组的心动过缓均自行缓解，无需治疗。两组均无咳嗽、低血压、心律失常、恶心或呕吐。
与单独使用右美托咪定相比，DISE 期间右美托咪定中加入小剂量布托啡诺（1mg）作为辅助治疗，可以减少右美托咪定的剂量，缩短达到充分镇静的时间，并提高操作者的满意度。这种协同组合可能是一种有前途的 DISE 镇静方案，在操作方便性和患者安全性方面具有优势。
