Related Experiment Video
Updated: Dec 13, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Hypoglossal Nerve Stimulator Placement for Pediatric Trisomy 21 Patients with Refractory Obstructive Sleep Apnea: A
Joelle B Karlik1, Nikhila Raol2, Laura Gilbertson1
1Department of Anesthesiology, Emory University School of Medicine, Egleston Children's Hospital of Children's Healthcare of Atlanta, 1405 Clifton Drive, Atlanta, GA 30307, USA.
Background:
Hypoglossal nerve stimulators (HNS) are an increasingly popular form of upper airway stimulation for obstructive sleep apnea (OSA) in adults who are unable to tolerate positive pressure treatment. However, HNS use is currently limited in the pediatric population.
Case Presentation:
We present a case series detailing the anesthetic management of three pediatric trisomy 21 patients receiving HNS for refractory obstructive sleep apnea. The patients tolerated the procedure well and experienced no complications. The average obstructive apnea-hypopnea index (AHI) change was 87.4% with the HNS.
Conclusions:
Proper anxiolysis, safe and controlled induction, multimodal analgesia, and minimization of post-operative respiratory compromise are all necessary to ensure anesthetic and surgical success. After a tailored anesthetic regimen, proper device placement and close follow-up, our patients had a marked improvement in obstructive symptoms.
Related Concept Videos
Sleep Apnea
The condition is more prevalent among...
Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
Suctioning the Nasopharyngeal Airway
Equipment Required
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Oxygen Delivering System III: Tracheostomy and T-piece
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...

