30 July 2014
A new simplified anesthesia procedure may enable more widespread use of preoperative testing to demonstrate the cause of airway obstruction in patients with severe sleep apnea.
This is according to a study in Anesthesia & Analgesia, which allowed doctors to put patients to sleep briefly but this was long enough to show the "obstructive anatomy" responsible for sleep apnea.
Dr Joshua H Atkins and Dr Jeff E. Mandel of the University of Pennsylvania and their colleagues developed the new "ramp control" technique.
Some 97 patients were used to analyse the anesthetic technique in a study of robot-assisted surgery for severe sleep apnea.
In order to conduct successful apnea surgery, it's important to accurately visualise the site of the obstruction in the upper airway. This is commonly done with a "drug-induced sleep endoscopy" (DISE) procedure but it's challenging to achieve just the right anesthetic dosage.
In the new ramp control approach, a computerised algorithm is used to calculate the two-dose sequence of anesthetic administration likely to produce sedation in each individual patient. By contrast, the standard stepwise approach to DISE uses a sequence of up to nine doses.
The 97 patients received no benefit from the standard treatment for sleep apnea and achieved the necessary level of sedation under the new approach.
Posted by Philip Briggs
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