{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:38:09Z","timestamp":1778866689683,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"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":[[2023,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Specific guidelines regarding an optimal general anesthesia (GA) approach to obstructive sleep apnea (OSA) patients remain undefined. Literature comparing the efficacy of total intravenous anesthesia (TIVA) and inhalational anesthesia in this population is sparse. We hypothesize that OSA patients receiving TIVA will experience reduced recovery times and other improved post\u2010surgical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Randomized controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult OSA patients undergoing upper airway surgery (hypoglossal nerve stimulation [HNS], nasal, or palate surgery) from February 2020\u2013December 2020 were included. A post\u2010anesthesia care unit (PACU) nursing survey documented patients' alertness, pain, oxygen supplementation, and postoperative nausea and vomiting from PACU arrival to 2\u2009hours. Perioperative timepoints from the electronic medical record (EMR) and a nurse\u2010estimated Phase I recovery time were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred eleven patients were included (46 TIVA and 65 inhalational anesthesia). Per EMR\u2010recorded timepoints, TIVA patients undergoing HNS and palate surgery experienced Phase I Time reductions of 12.5\u2009min (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.042) and 27.5\u2009min (<jats:italic>p\u2009=<\/jats:italic>\u00a00.016), respectively. Per the PACU survey, TIVA patients undergoing any surgery, HNS, or palate surgery experienced nurse\u2010estimated Phase I Time reductions of 16.5\u2009min (<jats:italic>p\u2009=<\/jats:italic>\u00a00.004), 12.5\u2009min (<jats:italic>p\u2009=<\/jats:italic>\u00a00.031), and 38.5\u2009min (<jats:italic>p\u2009=<\/jats:italic>\u00a00.024), respectively. Overall, TIVA patients experienced higher alertness and pain ratings, and lower oxygen supplementation requirements from PACU arrival to 30\u2009min (<jats:italic>p\u2009&lt;<\/jats:italic>\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with OSA receiving TIVA for GA maintenance during upper airway procedures experienced reduced recovery times and oxygen supplementation requirements, and a more rapid return to alertness. Future work toward developing optimized anesthetic guidelines for OSA patients is merited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 133:984\u2013992, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30438","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T14:24:20Z","timestamp":1665757460000},"page":"984-992","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Total Intravenous Anesthesia Versus Inhaled Sevoflurane in Obstructive Sleep Apnea Surgery: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-1510","authenticated-orcid":false,"given":"Leonard E.","family":"Estephan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7108-5118","authenticated-orcid":false,"given":"Sarah","family":"Sussman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8115-7098","authenticated-orcid":false,"given":"Matthew","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"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 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Thaler","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"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 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"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 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000623"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws342"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-016-0156-0"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3514"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.1448"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000053"},{"key":"e_1_2_7_8_1","volume-title":"General Anesthesia for Surgeons StatPearls","author":"Smith G","year":"2022"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_77_19"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-018-0632-3"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12713"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e3283310f6b"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29216"},{"key":"e_1_2_7_14_1","first-page":"661","article-title":"Modified PADSS (post Anaesthetic discharge scoring system) for monitoring outpatients discharge","volume":"84","author":"Palumbo P","year":"2013","journal-title":"Ann Ital Chir"},{"key":"e_1_2_7_15_1","unstructured":"Team RC.R: a language and environment for statistical computing. 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