Anesthesia for Drug Induced Sleep Endoscopy (DISE)

Drug-induced sleep endoscopy is a technique in which fiberoptic examination of the upper airway is performed under deep sedation and used to elucidate potential therapies. The most often utilized agents are propofol, midazolam, and dexmedetomidine.

We propose a protocol for Drug-induced sleep endoscopy using propofol and review its beneficial characteristics compared to midazolam and dexmedetomidine. Propofol has an ideal pharmacokinetic profile and provides adequate sedation that closely enough mimics the upper airway tone and respiratory pattern of natural sleep.

Drug-induced sleep endoscopy is performed to determine anatomically where sleep-disordered breathing takes place. There are several different anesthetic agents that can be utilized for this procedure, each with their own unique set of characteristics. Nevertheless, we believe that propofol is the agent that best simulates natural sleep to elucidate the site of obstruction.