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Updated: Sep 28, 2025
07:54
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
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A Protocol for Propofol-Infusion Drug-Induced Sleep Endoscopy
Taylor G Lackey1, James R Duffy1, Katherine K Green1
1Department of Otolaryngology-Head and Neck Surgery, University of Colorado Denver, Aurora, Colorado, USA.
Summary
This study introduces a safe propofol slow-infusion protocol for drug-induced sleep endoscopy (DISE). The findings establish normative values for propofol infusion rates during DISE, aiding procedural consistency.
Area of Science:
- Anesthesiology and Sleep Medicine
- Respiratory and Sleep Disorders
Background:
- Drug-induced sleep endoscopy (DISE) is crucial for diagnosing obstructive sleep apnea.
- Standardized propofol administration protocols are needed for reproducible DISE outcomes.
Purpose of the Study:
- To outline a novel protocol for drug-induced sleep endoscopy (DISE) using a slow propofol infusion without an initial bolus.
- To establish normative values for the final propofol infusion rate (Pfinal) and associated sedation depths during DISE.
Main Methods:
- Retrospective chart review of 246 patients undergoing DISE between 2016 and 2020.
- Analysis of patient demographics, DISE procedure details (including Pfinal, time to Pfinal, infusion rate changes), sedation depth (Bispectral Index, SedLine), and polysomnography data.
- Mixed linear models and Pearson correlation coefficients were used to analyze factors influencing Pfinal and its association with sedation depth and collapse patterns.
Main Results:
- The final propofol infusion rate (Pfinal) followed a normal distribution (mean ± SD, 156.44 ± 26.69 mcg/kg/min).
- Pfinal was significantly influenced by male sex, smoking status, time to Pfinal, and the number of propofol dose adjustments (P < .05).
- Sedation depth measurements differed between Bispectral Index and SedLine (P < .001), while collapse patterns were not associated with Pfinal (P > .05). No patients required advanced respiratory support.
Conclusions:
- A propofol slow-infusion DISE protocol is safe and reproducible.
- This protocol provides a standardized approach to DISE, contributing to consistent diagnostic outcomes.
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