{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T08:19:17Z","timestamp":1781597957602,"version":"3.54.5"},"reference-count":16,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Obstructive sleep apnea (OSA) is a prevalent sleep-disordered breathing pathology with significant clinical consequences, including increased cardiovascular risk and cognitive decline. Continuous positive airway pressure (CPAP) is the gold-standard treatment, but alternative strategies are sometimes needed for patients intolerant to CPAP. Drug-induced sleep endoscopy (DISE) is a key diagnostic tool for assessing upper airway obstruction in OSA patients and subsequently tailoring a surgical approach, with sedation protocols playing a crucial role in its efficacy and results accuracy. This study aimed to investigate the effect of adding remifentanil to a propofol target-controlled infusion (TCI) regimen on the sedation parameters and procedural outcomes of DISE. Materials and\u00a0Methods: The study was conducted at the Central University and Emergency Military Hospital \u201cDr. Carol Davila\u201d and Ria Clinic in Bucharest between July 2021 and October 2023. Thirty-one patients were enrolled and randomised into two groups: a propofol group (P group, n= 11) and a remifentanil-propofol group (R-P group, n = 20). DISE was performed using standardised protocols, sedative drugs were administered in TCI mode, and data on sedation levels, respiratory and cardiovascular parameters, and procedural incidents were collected. Results: The addition of remifentanil at 1 ng\/mL effect-site concentration significantly reduced the effect-site concentration of propofol required for adequate sedation (3.4 \u00b1 0.7 \u00b5g\/mL in the P group vs. 2.8 \u00b1 0.6 \u00b5g\/mL in the R-P group, p = 0.035). The time to achieve adequate sedation was also shorter in the R-P group (7.1 \u00b1 2.5 min vs. 9.5 \u00b1 2.7 min, p = 0.017). The incidence of cough, hypoxemia, and cardiovascular events did not significantly differ between the two groups. Conclusions: Adding remifentanil to a propofol TCI regimen for DISE effectively reduces the required propofol effect-site concentration and shortens sedation time without increasing the risk of adverse events. This combination may enhance the safety and efficiency of DISE, offering a promising alternative for patients undergoing this procedure.<\/jats:p>","DOI":"10.3390\/medicina60071123","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T08:16:57Z","timestamp":1720772217000},"page":"1123","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Study of Two Sedative Protocols for Drug-Induced Sleep Endoscopy: Propofol versus Propofol-Remifentanil Combination, Delivered in Target-Controlled Infusion Mode"],"prefix":"10.3390","volume":"60","author":[{"given":"Narcis-Valentin","family":"T\u0103nase","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Dr. Carol Davila Central University and Emergency Military Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u0103zvan","family":"Hain\u0103ro\u0219ie","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u0103cr\u0103mioara-Aurelia","family":"Br\u00eendu\u0219e","sequence":"additional","affiliation":[{"name":"Department of Public Health and Management, Carol Davila University of Medicine and Pharmacy, 050463 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1142-7427","authenticated-orcid":false,"given":"Cristian","family":"Cobilinschi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Clinic of Anesthesiology and Intensive Care, Clinical Emergency Hospital, 014461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5511-8702","authenticated-orcid":false,"given":"Madalina","family":"Dutu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Dr. Carol Davila Central University and Emergency Military Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1170-0614","authenticated-orcid":false,"given":"Dan","family":"Corneci","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Dr. Carol Davila Central University and Emergency Military Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viorel","family":"Zainea","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"210082","DOI":"10.1183\/20734735.0082-2021","article-title":"Defining obstructive sleep apnoea syndrome: A failure of semantic rules","volume":"17","author":"Riha","year":"2021","journal-title":"Breathe"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: A literature-based analysis","volume":"7","author":"Benjafield","year":"2019","journal-title":"Lancet Respir. 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