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Updated: Jun 9, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Drug-induced sleep endoscopy: conventional versus target controlled infusion techniques--a randomized controlled
Andrea De Vito1, Vanni Agnoletti, Stefano Berrettini
1Head and Neck Surgery and Oral Surgery Unit, Department of Special Surgery, Morgagni-Pierantoni Hospital, Via Forlanini, 34, Forlì 47100, Italy. andrea_devito@fastwebnet.it
Summary
Target-controlled infusion drug-induced sleep endoscopy (DISE-TCI) offers superior accuracy and stability for observing pharyngeal collapse in obstructive sleep apnea-hypopnea syndrome patients compared to conventional DISE methods.
Area of Science:
- Otolaryngology
- Sleep Medicine
- Anesthesiology
Background:
- Pharyngeal collapse sites are crucial for surgical decisions in obstructive sleep apnea-hypopnea syndrome (OSAHS).
- Drug-induced sleep endoscopy (DISE) visualizes the upper airway during sedation.
- Conventional DISE uses manual bolus injections for sedation.
Purpose of the Study:
- To compare the efficacy and safety of target-controlled infusion DISE (DISE-TCI) against conventional DISE.
- To assess the accuracy of apneic event observation and pharyngeal collapse patterns.
- To evaluate the stability and safety of sedation plans during DISE procedures.
Main Methods:
- A prospective, randomized, unicenter study involving 40 OSAHS patients.
- Patients were allocated to either conventional DISE (bolus injection) or DISE-TCI groups.
- Primary endpoint: apneic event observation and correlation with pharyngeal collapse.
Main Results:
- Complete apnea events were observed in 85% of DISE-TCI patients versus 20% in conventional DISE (P < 0.0001).
- Sedation plan instability occurred in 5% of DISE-TCI patients compared to 65% in conventional DISE (P = 0.0001).
- No significant difference in oxygen requirement due to desaturation (P = 0.4872).
Conclusions:
- DISE-TCI demonstrates significantly increased accuracy in identifying pharyngeal collapse sites during sleep endoscopy.
- The target-controlled infusion technique provides superior sedation stability and safety.
- DISE-TCI is recommended as the preferred method for sleep endoscopy in OSAHS patients.
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