Is There a Perfect Drug for Sedation in DISE

Drug-induced sleep endoscopy (DISE) provides additional information about upper airway sites and patterns of narrowing in obstructive sleep apnea. There is a great variability on drugs chosen for DISE in the literature. In this systematic review, we looked for differences in obstruction patterns, as well as cardiovascular, neurological, or respiratory differences between the different drugs. All drugs reproduced a similar upper airway collapse on DISE. Propofol and midazolam showed a higher rate of respiratory depression; however, propofol has better pharmacokinetic properties. Dexmedetomidine has a safer respiratory profile and diminishes nausea, cough, sneeze reflexes, and saliva secretion, but holds a lower cardiovascular security. The ideal drug for DISE has not been found yet; each of these existing drugs has its advantages and disadvantages. The right drug should be chosen by the surgeon and/or the anesthetists’ preferences and the patient’s condition.