{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:40:47Z","timestamp":1778866847281,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T00:00:00Z","timestamp":1604361600000},"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":[[2021,4]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>There is currently no standard of care in terms of anesthesia modality for patients receiving upper airway surgery with comorbid obstructive sleep apnea (OSA). Although both total intravenous anesthesia (TIVA) and volatile gas anesthesia are commonly utilized in ambulatory otolaryngology surgery, it is currently unclear if there are any advantages with one modality over the other. We hypothesize that patients receiving upper airway surgery with comorbid OSA will have quicker recovery times with TIVA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review from January 2019 to December 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients aged 18 and older receiving upper airway surgery (upper airway stimulation, nasal surgery, modified uvulopalatopharyngoplasty) were included. Patients were excluded when there was incomplete or missing data in the electronic medical record.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010six patients received gas anesthesia and 62 patients received TIVA. Phase I recovery times were significantly reduced by surgery and by severity of OSA: nasal surgery, upper airway stimulation, and modified uvulopalatopharyngoplasty had a reduction of 35.5\u2009minutes (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), 42.5\u2009minutes (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), and 36\u2009minutes (<jats:italic>P<\/jats:italic> = .022), respectively. In terms of severity, mild, moderate, and severe OSA had reductions of 23.5\u2009minutes (<jats:italic>P<\/jats:italic> = .004), 52\u2009minutes (<jats:italic>P<\/jats:italic> = .004), and 47\u2009minutes (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), respectively. The severity of OSA generally correlated with increased time spent in Phase I: as severity increased, Phase I time increased by 16.8\u2009minutes for the gas cohort (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), whereas in the TIVA cohort, it increased only 4.3\u2009minutes (<jats:italic>P<\/jats:italic> = .489).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients having upper airway surgery with comorbid OSA that received TIVA (propofol and remifentanil) spent significantly less time in Phase I and the recovery room overall compared to those receiving volatile gas anesthesia in the form of sevoflurane, and this correlated with the severity of OSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3. <jats:italic>Laryngoscope<\/jats:italic>, 131:925\u2013931, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29216","type":"journal-article","created":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T19:09:14Z","timestamp":1604430554000},"page":"925-931","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Reduced Recovery Times with Total Intravenous Anesthesia in Patients with Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8115-7098","authenticated-orcid":false,"given":"Matthew","family":"Stewart","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard","family":"Estephan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Thaler","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Zhan","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics Thomas Jefferson University  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Connors","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kabir","family":"Malkani","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurits","family":"Boon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4637-3630","authenticated-orcid":false,"given":"Colin","family":"Huntley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,3]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1079","article-title":"Sleep apnea as an independent risk factor for all\u2010cause mortality: the Busselton Health Study","volume":"31","author":"Marshall NS","year":"2008","journal-title":"Sleep"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/147.4.887"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-012-0141-x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.08.1070"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AIA.0b013e3181755da5"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14428"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200310000-00010"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12713"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-018-0632-3"},{"key":"e_1_2_6_11_1","volume-title":"GraphPad Prism version 8.4 for Mac","year":"2020"},{"key":"e_1_2_6_12_1","volume-title":"R: A language and environment for statistical computing. R Foundation for Statistical Computing","year":"2020"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25399"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.2344\/0003-3006-55.4.124"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.bja.a013467"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0952-8180(02)00367-7"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.1999.01005.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2018.06.018"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000103187.70627.57"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00008506-200110000-00003"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29216","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29216","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29216","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T00:48:01Z","timestamp":1693702081000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,3]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1002\/lary.29216"],"URL":"https:\/\/doi.org\/10.1002\/lary.29216","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,3]]},"assertion":[{"value":"2020-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}