Journal of Dental Anesthesia and Pain Medicine  2017;17(1):71-76

doi:10.17245/jdapm.2017.17.1.71

Anesthetic management for simultaneous drug-induced sleep endoscopy and maxillomandibular advancement in a patient with obstructive sleep apnea.

Tae Seong KUK 1 ; Eunsun SO ; Myong Hwan KARM ; Jimin KIM ; Seong In CHI ; Hyun Jeong KIM ; Kwang Suk SEO ; Sung Woon ON ; Jin Young CHOI

Affiliations

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Keywords

Drug Induced Sleep Endoscopy; Obstructive Sleep Apnea; Propofol

Country

Republic of Korea

Language

English

Abstract

Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made. When inducing deep sedation in a patient with OSA, airway obstruction may increase, causing oxygen saturation to drop; airway interventions are necessary in such cases. Effective DISE and MMA surgery can be performed by administering propofol through target-controlled infusion while monitoring the bispectral index (BIS).