{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:01:54Z","timestamp":1793383314378,"version":"4.5.0"},"reference-count":52,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T00:00:00Z","timestamp":1536278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Drug\u2010induced sleep endoscopy (DISE) has gained interest for upper airway evaluation in patients with snoring and obstructive sleep apnea (OSA), and different drugs have been used to induce sedation. Nevertheless, all drugs have presented specific advantages and disadvantages with differential effects on respiratory physiology. This study evaluated and compared the effects of midazolam, propofol and dexmedetomidine on DISE findings, O<jats:sub>2<\/jats:sub>nadir, and bispectral index (BIS) in the same sample of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series prospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients who elected to undergo surgery for OSA treatment and were intolerant to conservative therapies underwent DISE with propofol, dexmedetomidine, and midazolam between July 2015 and July 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two patients were analyzed, and 43 (82.7%) were men. Agreement among drugs for both degree and patterns of obstruction was excellent at all sites (velum, oropharynx, and epiglottis) except for the tongue base. Dexmedetomidine had the least complete collapse sites and highest O<jats:sub>2<\/jats:sub>nadir and was the only drug for which apnea severity and obstruction levels (upper, lower, or combined) were correlated. The variability among drug treatments for the BIS index was considerable, and propofol had the lowest variability and average value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Drug selection had a relevant influence in DISE findings. Compared with dexmedetomidine, midazolam and propofol presented higher incidence of tongue base collapse, lower O<jats:sub>2<\/jats:sub>levels, and lower BIS index values. Propofol resulted in an O<jats:sub>2<\/jats:sub>nadir that most resembled that observed during polysomnography. The BIS index variability differed among drugs, and its use was considered relevant for sedation orientation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4<jats:italic>Laryngoscope<\/jats:italic>, 129:506\u2013513, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27298","type":"journal-article","created":{"date-parts":[[2018,9,8]],"date-time":"2018-09-08T13:08:52Z","timestamp":1536412132000},"page":"506-513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["The Effect of Sedating Agents on Drug\u2010Induced Sleep Endoscopy Findings"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9393-1757","authenticated-orcid":false,"given":"Alon\u00e7o","family":"Viana","sequence":"first","affiliation":[{"name":"Program of Neurology Rio de Janeiro Brazil"},{"name":"Department of Otorhinolaryngology Marc\u00edlio Dias Naval Hospital (HNMD) Rio de Janeiro Brazil"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Sleep Surgery Stanford University Stanford California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6253-7522","authenticated-orcid":false,"given":"Chen","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Sleep Surgery Stanford University Stanford California U.S.A."},{"name":"Department of Otorhinolaryngology First Affiliated Hospital of China Medical University Shenyang People's Republic of China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talita","family":"Rosa","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaldo","family":"Couto","sequence":"additional","affiliation":[{"name":"Department of Pharmacy West Zone Rio de Janeiro State University (UEZO) Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise Duprat","family":"Neves","sequence":"additional","affiliation":[{"name":"Program of Neurology Rio de Janeiro Brazil"},{"name":"Department of Cardiopulmonary Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Helena","family":"Ara\u00fajo\u2010Melo","sequence":"additional","affiliation":[{"name":"Program of Neurology Rio de Janeiro Brazil"},{"name":"Department of Otorhinolaryngology Federal University of the State of Rio de Janeiro (UNIRIO) Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robson","family":"Capasso","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Sleep Surgery Stanford University Stanford California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.4.9712063"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197808000-00012"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1991.tb02103.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-010-1376-y"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2548-3"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815625972"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-015-1127-9"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-017-1491-8"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-017-4597-5"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.26"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000157849.16649.6e"},{"key":"e_1_2_6_13_1","first-page":"5691","article-title":"Comparison of dexmedetomidine and propofol used for drug\u2010induced sleep endoscopy in patients with obstructive sleep apnea syndrome","volume":"8","author":"Kuyrukluyildiz U","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875-9114.1985.tb03411.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1983.tb02271.x"},{"key":"e_1_2_6_16_1","unstructured":"Midazolam Official FDA information side effects and uses. 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