Abstract
Dexmedetomidine is a suitable sedative for awake fiberoptic intubation in patients with obstructive sleep apnea (OSA). However, previous studies have shown that dexmedetomidine delays recovery from propofol-remifentanil anesthesia. This study aimed to determine whether doxapram may hasten the recovery following dexmedotomidine-propofol-remifentanil anesthesia. Sixty patients scheduled for uvulopalatopharyngoplasty with total intravenous anesthesia were randomized to two groups according to the medicine given at the end of surgery. These were the doxapram (1 mg/kg) and control (normal saline) groups (n=30 per group). The primary outcome was the time to eye opening on verbal command. The time to return to spontaneous breathing, to hand squeezing in response to verbal command, to extubation of the trachea, and the heart rate (HR), bispectral index (BIS) values, respiratory rate (RR) and pulse oximetry values were also recorded and compared. The time to return to spontaneous breathing (5.2±2.9 vs. 11.7±3.4 min, P<0.001), eye opening (9.3±4.7 vs. 15.9±6.3 min, P<0.001), hand squeeze to command (11.8±6.5 vs. 17.6±7.7 min, P=0.0026) and extubation (14.2±7.8 vs. 19.2±9.6 min, P=0.0308) were significantly shorter in the doxapram group compared with the control group. BIS scores (at 3–14 min), RR (at 4–10 min) and HR (at 2–13 min) were significantly higher in the doxapram group compared with those in the control group (P<0.05). Doxapram hastens the recovery from dexmedetomidine-propofol-remifentanil anesthesia in patients undergoing uvulopalatopharyngoplasty, and may benefit patients with OSA.
Highlights
General anesthesia with a secured airway is recommended for patients undergoing uvulopalatopharyngoplasty for obstructive sleep apnea (OSA) [1]
The main finding of this study is that the recovery from dexmedetomidine‐propofol‐remifentanil anesthesia in patients with OSA undergoing elective uvulopalatopharyngoplasty is hastened by doxapram (1 mg/kg i.v.)
Dexmedetomidine has been demonstrated to delay the recovery from propofol anesthesia when used to maintain the anesthesia or to induce anesthesia in minor surgery due to its longer half‐life (≥2 h) [7,8,9]
Summary
General anesthesia with a secured airway is recommended for patients undergoing uvulopalatopharyngoplasty for obstructive sleep apnea (OSA) [1]. Securing the airway and reducing the postoperative respiratory compromise should be considered when selecting anesthetics. Dexmedetomidine may be a useful adjuvant during general anesthesia, for OSA patients, by promoting hemodynamic stability and decreasing the doses of anesthetics and analgesics, which may allow early recovery and reduce potential postoperative respiratory compromise [5,6]. Studies have shown that dexmedetomidine delays recovery from propofol or propofol‐remifentanil anesthesia [7,8]. Propofol and propofol‐remifentanil are commonly used anesthetics for patients with OSA undergoing uvulopalatopharyngoplasty [9,10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
