Synchronized mandibular movement and capnography: a novel approach to obstructive airway detection during procedural sedation —a post hoc analysis of a prospective study

AbstractPerioperative complications related to obstructive sleep apnea still occur despite the use of partial pressure end-tidal CO2\(\left( {{{\text{P}}_{{\text{ETC}}{{\text{O}}_2}}}} \right)\) and pulse oximetry. Airway obstruction can complicate propofol sedation and a novel monitor combining mandibular movement analysis with capnography may facilitate its detection. Patients scheduled for sleep endoscopy were recruited and monitored with standard monitoring,\({{\text{P}}_{{\text{ETC}}{{\text{O}}_2}}},\) and Jaw Activity (JAWAC) mandibular movement sensors. A post hoc analysis investigated airway obstruction prediction using a Respiratory Effort Sequential Detection Algorithm (RESDA) based on\({{\text{P}}_{{\text{ETC}}{{\text{O}}_2}}}\) and mandibular movement signals. 21 patients were recruited and 54 episodes of airway obstruction occurred. RESDA detected obstructive apnea [mean  ± SD (median)] 29 ± 29 (21) s, p 
Source: Journal of Clinical Monitoring and Computing - Category: Information Technology Source Type: research

Related Links:

Publication date: Available online 23 November 2019Source: American Journal of OtolaryngologyAuthor(s): Michael Eggerstedt, Matthew J. Urban, Emily Chi, Ethan M. Ritz, Phillip LosavioAbstractPurposeDrug-induced sleep endoscopy (DISE) is a cost-effective, safe, and reliable tool to evaluate obstructive sleep apnea (OSA) patients by revealing upper airway sites, patterns, and severity of obstruction. DISE provides valuable data because reliable evaluation of the OSA airway while awake has remained elusive. Few studies (with mixed results) have analyzed the correlation between pre-operation, awake airway assessments routinely...
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
CONCLUSIONS: The NAPS method of sedation for DISE seems safe and feasible when performed by trained staff in a hospital setting. PMID: 30364918 [PubMed - as supplied by publisher]
Source: Rhinology - Category: ENT & OMF Tags: Rhinology Source Type: research
CONCLUSIONS: Use of remifentanil during DISE reduces the target concentration of propofol required for patient sedation to perform DISE without respiratory depression. PMID: 30324545 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
ConclusionsUse of remifentanil during DISE reduces the target concentration of propofol required for patient sedation to perform DISE without respiratory depression.
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
Publication date: Available online 7 September 2018Source: Egyptian Journal of AnaesthesiaAuthor(s): Essam F. AbdelgalelAbstractBackgroundThe aim of this study was to evaluate if the addition of dexmedetomidine to propofol could improve the success and reduce the complications during drug induced sleep endoscopy in obstructive sleep apnea patients.Patient and methodsFifty adult patients scheduled for drug induced sleep endoscopy were randomly allocated to one of two groups. Group P (25 patients) received propofol loading dose of 0.5 mg/kg over 3 min then continuous infusion in a dose of 25–75 mcg/kg/min. Group ...
Source: Egyptian Journal of Anaesthesia - Category: Anesthesiology Source Type: research
Purpose of review Provide a practical update on drug-induced sleep endoscopy (DISE) for anesthesia providers, which can also serve as a reference for those preparing to establish a DISE program. Recent findings New developments in surgical approaches to OSA and the growing global incidence of the condition have stimulated increased interest and demand for drug-induced sleep endoscopy. New techniques include transoral robotic surgery and hypoglossal nerve stimulation. Recent DISE literature has sought to address numerous debates including relevance of DISE findings to those during physiologic sleep and the most appropr...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: MORBID OBESITY AND SLEEP APNEA: Edited by Frances F. Chung Source Type: research
Introduction: Drug-induced sleep endoscopy (DISE) offers an unique evaluation of the upper airway pathology, that can lead to obstructive sleep apnea syndrome (OSAS). In both fiberoptic bronchoscopy (FOB) and DISE, similar sedative agents are used. It is thought that the upper airways can be evaluated in terms of functional and anatomic pathology during the FOB procedure. The aim of this study is to investigate the relationship between polysomnography scores and upper airway scores during routine FOB.Methods: Fifty patients who undergone FOB were included to the study. After the sedation protocol applied by an anesthesiolo...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and Control of Breathing Source Type: research
Purpose of review The purpose of this article is to review complications and unplanned hospital admissions in patients presenting for ambulatory procedures requiring anesthesia care in the gastrointestinal endoscopy, bronchoscopy, and radiology suites. Recent findings The range of ambulatory diagnostic and therapeutic procedures being undertaken in the gastrointestinal endoscopy, bronchoscopy, and radiology suites is expanding rapidly. Recent observational studies in gastrointestinal endoscopy confirm low incidences of complications and unplanned admissions. Deep propofol-based sedation is associated with more complic...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Susan Dabu-Bondoc Source Type: research
Maxillomandibular advancement is an effective surgical treatment for medically refractory moderate to severe obstructive sleep apnea. Different degrees and vectors of bony advancements increase upper airway dimensions as a result of their soft tissue attachments. Previous studies have analyzed clinical efficacy by demonstrating increased airway dimension on pre and post-operative imaging, sleep study results, and drug induced sleep endoscopy (DISE). These studies are limited to analyzing the effects of single movements.
Source: Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Tags: Oral Abstract Track Two: Anesthesia, Infection, OSA, Orthognathic Source Type: research
Authors: Revesloot MJL, Benoist L, van Maanen P, Kezirian EJ, de Vries N Abstract Drug-induced sleep endoscopy was introduced in 1991 and has recently evolved into a pivotal instrument for patients in whom obstructive sleep apnea surgery is considered. Here, we discuss the indications, contraindications, technique, anesthesia, scoring systems, validity, and insights of the literature. PMID: 28738362 [PubMed - in process]
Source: Advances in Oto-Rhino-Laryngology - Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
More News: Anesthesia | Anesthesiology | Diprivan | Endoscopy | Information Technology | Obstructive Sleep Apnea | Propofol | Respiratory Medicine | Sleep Apnea | Sleep Disorders | Sleep Medicine | Study