Effects of propofol and dexmedetomidine in sleep videoendoscopy: a comparative study in Ukraine

Introduction: Snoring and obstructive sleep apnea (OSA) are associate with a high socio-economic burden. According to statistics snoring is found in 44% of men and 28% of women aged 30 to 60 years. Treatment involves several main approaches including uvulopalatopharyngoplasty with or without tonsillectomy. Preparation for this procedure includes sleep videoendoscopy. Currently, we mainly use two effective agents, propofol and dexmedetomidine. That said, there is still no consensus on which one is safer and better. Material and methods: The study involved 50 people aged 18 to 62 with a history of snoring and OSA, previously ineligible or insensitive to CPAP therapy, thus preparing for surgical treatment of these disorders. All patients were randomized to two study groups: group 1 with propofol as a sedative and group 2 with dexmedetomidine. Each treatment was divided into three periods: (1) initial testing before the use of intravenous hypnotic agents, (2) sedation, and (3) regaining consciousness. In each period, we measured the following parameters: minute ventilation, respiratory rate, oxygen saturation, blood concentration of hypnotic agent, BIS index. Statistical analysis was performed on IBM SPSS Statistics v. 22. Results: The OAA/S scale showed that the recovery time after sedation was longer for dexmedetomidine than for propofol: 38 ± 10 min and 27 ± 3 min, respectively (p value = 0.305, which means no statistically significant difference between the groups). Based on monitoring of circulation and respiratory rate, heart rate tended to decrease with dexmedetomidine seda tion and increase with propofol infusion. Blood pressure tended to drop in both groups, more so with dexmedetomidine. In the post-sedation period, blood pressure stabilized faster in the propofol group than in the dexmedetomidine group, but it was not statistically significant. Conclusion: According to the study results, there was no statistically significant difference between the propofol or dexmedetomidine groups. However, the paper presents a small series of cases, therefore extensive clinical research is needed to clarify the problem further.