title: Dexmedetomidine versus propofol during drug-induced sleep endoscopy and sedation: a systematic review.
abstract: BACKGROUND
  The purpose of the present study is to review the international literature, using a systematic review, for studies comparing propofol and dexmedetomidine for drug-induced sleep endoscopy (DISE) or sedation in which there is a description of the effect of the agents on the upper airway and associated variables (e.g., vital signs, sedation scores).
  
  
  METHODS
  This is a systematic review through October 4, 2016. PubMed/MEDLINE and four additional databases were accessed for this study.
  
  
  RESULTS
  Two hundred twenty studies were screened, 79 were downloaded, and 10 met criteria. The majority of the studies identified dexmedetomidine as the preferred pharmacologic agent for DISE due to an overall safer and more stable profile based upon hemodynamic stability. However, propofol provided greater airway obstruction with oxygen desaturations. With either agent, the degree of obstruction in the upper airway lacks some degree of validity as to whether the obstructions accurately represent natural sleep or are simply a drug-induced effect.
  
  
  CONCLUSIONS
  Dexmedetomidine and propofol have their advantages and disadvantages during DISE. Generally, dexmedetomidine was preferred and seemed to provide a more stable profile based upon cardiopulmonary status. However, propofol has a quicker onset, has a shorter half-life, and can demonstrate larger degrees of obstruction, which might more accurately reflect what happens during REM sleep. Additional research is recommended.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96859, USA. etchan78@gmail.com.
authors.forename: Edward T
authors.initials: ET
authors.lastname: Chang
authors.affiliation: Department of Otorhinolaryngology/Sleep Medicine Centre, Hospital CUF, Porto, Portugal.|CINTESIS Center for Research in Health Technologies and Information Systems, University of Porto, Porto, Portugal.
authors.forename: Victor
authors.initials: V
authors.lastname: Certal
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96859, USA.
authors.forename: Sungjin A
authors.initials: SA
authors.lastname: Song
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery Division of Sleep Surgery and Medicine, Stanford Hospital and Clinics, Stanford, CA, USA.
authors.forename: Soroush
authors.initials: S
authors.lastname: Zaghi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario Doctor Peset, 46017, Valencia, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Carrasco-Llatas
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Torre
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery Division of Sleep Surgery and Medicine, Stanford Hospital and Clinics, Stanford, CA, USA.
authors.forename: Robson
authors.initials: R
authors.lastname: Capasso
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery Division of Sleep Surgery and Medicine, Stanford Hospital and Clinics, Stanford, CA, USA.|Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Redwood City, CA, USA.
authors.forename: Macario
authors.initials: M
authors.lastname: Camacho
mesh_terms: D000758:Anesthesia / Q000379:methods*; D020927:Dexmedetomidine / Q000494:pharmacology*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D015742:Propofol / Q000494:pharmacology*; D012890:Sleep / Q000187:drug effects*
chemical_list: D020927:Dexmedetomidine; D015742:Propofol
keywords: DISE; Dexmedetomidine; Obstructive sleep apnea (OSA); Propofol; Sleep apnea syndromes; Systematic review