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Internal Grant Competition DGC
START-UP grant

Anesthesiological management during drug-induced sleep endoscopy
Project IdSGS03/LF/2023
Main solverMUDr. Markéta Bílená
Period1/2023 - 12/2023
ProviderSpecifický VŠ výzkum
AnotationAnesthesiological management during drug-induced sleep Sleep endoscopy in pharmacology-induced sedation/anesthesia (Drug-induced sleep endoscopy - DISE) is a diagnostic method for the localization of obstruction in upper airways and assessment of its severity in patients suffering from obstructive sleep apnea (OSA). This diagnostic procedure enables personalized treatment for these patients. Obstructive sleep apnea is characterized by recurring episodes of partial or complete closure of upper airways during sleep, leading to desaturation and re-oxygenation, followed by overstimulation of the sympathetic nervous system, causing sleep disturbances, resulting in daytime sleepiness. The prevalence of obstructive sleep apnea associated with hypersomnolence is approximately 3-7% in males and 2-5% in females. Prevalence is increasing because of the aging population and rising obesity rates worldwide. The configuration of upper airways in a conscious state and sleep differs, and anesthesiological management aims to reach a level of sedation resembling physiological sleep. Drug-induced sleep leads to relaxed muscle tone of upper airways and obstruction, which can be visualized and defined using flexible endoscopy. The quality of providing sedation affects the results of DISE. Patient safety is of utmost importance given the significant risks arising from OSA (obesity, anatomical abnormalities of upper airways), which can result in a critical scenario of cannot intubate and cannot oxygenate (CICO). Therefore, patients will be closely monitored (ECG, blood pressure, heart rate, saturation, end-tidal CO2) and depth of anesthesia by bispectral index (BIS). Propofol is the drug of choice for sedation; its dose will be either manually administered or by target-control infusions (TCI).