Dexmedetomidine added to propofol for drug-induced sleep endoscopy in adult patients with obstructive sleep apnea: Randomized controlled trial

Abstract

BackgroundThe 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 PD (25 patients) received propofol infusion as group P and dexmedetomidine intravenous infusion with a loading dose of 0.5 mcg/kg over 5 min then continuous infusion in a dose of 0.2–0.7 mcg/kg/h. The primary outcome was successful completion of the procedure. The secondary outcomes included the time to start endoscopy, procedure duration, the incidence of adverse events and surgeons and patients satisfaction.ResultsSuccessful completion of the procedure was significantly higher in group PD (96%) compared to group P (72%). The total propofol dose needed/patient (mg) was significantly more in group P compared to group PD (173.5 ± 41.6 versus98.4 ± 19.8 with shorter recovery time in group PD. Both surgeons and patients satisfaction were significantly higher in group PD compared to group P. The incidence of cough and gag reflexes were significantly higher in group P compared to group PD. Heart rate (HR) was significantly lower in group PD compared to group P at 5, 10, 15, 20, 25 and 30 min from the start of the studied drugs. Respiratory rate (RR) was significantly lower in group P compared to group PD at 5, 10, 15 and 20 min from the start of the studied drugs (p < 0.05).ConclusionAddition of dexmedetomidine to propofol is associated with higher incidence of successful completion of the procedure with faster recovery. Cough and gag reflexes were significantly lower with the addition of dexmedetomidine with higher surgeons and patients satisfaction.