Bispectral index guided sedation during drug-induced sleep endoscopy: A clinical study towards standardized airway assessment in obstructive sleep apnea
Keywords:
Obstructive Sleep Apnea, Sleep Endoscopy, DISE, Bispectral index, BIS, Anesthesia Monitoring, Propofol, Target controlled infusion, TCI, Electroencephalography, Conscious Sedation, Airway ObstructionAbstract
Background: Drug-Induced Sleep Endoscopy (DISE) identifies the anatomical level and pattern of airway obstruction in Obstructive Sleep Apnea (OSA). Variations in sedation depth may influence airway findings and recovery. This quality improvement study evaluated whether Bispectral Index (BIS) guided sedation improves procedural consistency and recovery outcomes during DISE.
Methods: A prospective clinical audit compared, Conventional DISE using clinical assessment of sedation with/against DISE performed using Target-Controlled Infusion (TCI) of Injection Propofol guided by BIS monitoring. A BIS range of 65–75 was maintained. Endpoints included total sedative consumption, additional bolus requirement, number of agents per case, airway collapse patterns, recovery time (modified Aldrete score ≥9), and respiratory adverse events.
Results: After implementation of BIS monitoring, total sedative consumption and additional bolus requirements decreased. Fewer cases require multiple sedative agents. Airway collapse patterns were more consistent, and recovery time was shorter in the BIS-guided phase.
Conclusion: BIS-guided sedation during DISE improves procedural consistency and recovery characteristics. Objective monitoring may enhance reliability of airway evaluation in OSA.
