Feasibility and validity of dexmedetomidine as a drug to induce sleep for fibrolaryngoscopy assay in patients with sleep apnea-hypopnea syndrome: a randomized controlled trial

Abstract

Objective To evaluate the feasibility and efficacy of dexmedetomidine (Dex) induced sleep for fibrolaryngoscopy in patients with sleep apnea-hypopnea syndrome. Methods Eighty-eight inpatients with sleep apnea-hypopnea syndrome (SAHS) were randomly divided into 2 groups: Propofol group (group P) and Dex group(group D). Each group had 44 cases. In group P, patients were intravenously injected with 2 mg/kg propofol, while in group D, 1 μg/kg dex was intravenously administered with a pump over 15 min. The MAP, HR, and SpO2 of patients were recorded before administration of the drug(T0), immediately after falling asleep(T1) and after fibrolaryngoscopy operation(T2), and by the end of fibrolaryngoscopy assay(T3). Additional parameters were also analyzed, such as, time to fall asleep, observer's assessment of alertness/sedation scale(OAA/S), time of endoscopic examination, time to wake up after examination, the number of patients required mask ventilation, the satisfaction of patients and examiners, and false-positive cases of fibrolaryngoscopy assay. Results Compared with patients in group D, patients in group P fell asleep faster, exhibited lower MAP and SpO2 immediately after falling asleep (P<0.05), but longer time to finish fibrolaryngoscopy and longer time to wake up after examination. More group P patients required mask ventilation and needed further assessment to exclude false-positive signs in fibrolaryngoscopy. Conclusions Dex may be a better intervention to induce sleep for fibrolaryngoscopy assay of sleep apnea-hypopnea syndrome in term of safety and validity of the examination. Key words: Dexmedetomidine; Sleep apnea-hypopnea syndrome; Fibrolaryngoscopy