Aishwarya, C (2022) Changes in the Finding of Drug Induced Sleep Endoscopy in Accordance with Depth of Sleep Measured by Bispectral Index in Obstructive Sleep Apnoea. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Obstructive sleep apnoea is a component of sleep disordered breathing and is characterised by repetitive partial or complete collapse of upper airway during sleep, resulting in disruption of normal sleep architecture and usually associated with arterial desaturations. If these respiratory events occur more than five times per hour of sleep and are associated with symptoms, most commonly snoring, excessive daytime fatigue, and witnessed apnoea, the term obstructive sleep apnoea/ hypopnoea syndrome (OSAS) is applied. AIMS AND OBJECTIVES: 1. To prospectively evaluate the changes in degree and site of upper airway collapsibility according to change in depth of sedation as determined by bispectral index in Drug induced sleep endoscopy in OSA patients. 2. To evaluate the usefulness of Bispectral index in accessing effects of sedation depth on DISE. 3. To improve the chances of successful outcome after sleep surgery by accurately determining the site of obstruction in OSAS patients. MATERIALS AND METHODS: STUDY PLACE: Rajiv Gandhi Government General Hospital, Chennai -600003. STUDY DESIG : Retrospective and Prospective, non-interventional study. STUDY PERIOD: November 2020 to November 2021. SAMPLE SIZE: 36. ETHICAL CLEARANCE: obtained. INCLUSION CRITERIA: 1) Patients diagnosed with OSA i.e., AHI (apnoea hypopnoea index) >5 in polysomnagraphy, 2) Age 18 to 60 years, 3) BMI < 40. EXCLUSION CRITERIA: 1) Age group: <18 years and > 60 years, 2) Craniofacial abnormalities, 3) Previous upper airway surgery, 4) Neuromuscular disorders, 5) Patients with high surgical risk according to classification of the American society of anaesthesiologists (ASA) i.e., greater than ASA class III. DATA COLLECTION: 1) Complete history taking and clinical examination, 2) Clinical examination, 3) Polysomnography, 4) DISE finding, 5) BIS monitoring. CONCLUSION: Drug induced sleep endoscopy is better indicated when the depth of sleep is between Bispectral index of 60 and 80. It is advisable not to look into the level of obstruction when BIS index is more than 80 and it is only between 60-80 we see maximum collapse. When the patient goes in for hypotonia, due to sleep which is indicated by EMG score on the BIS monitor, augmented snoring and hypoxia occurs. This study concludes DISE done along with BIS monitor gives a better evaluation of airway in OSAS patients. At a critical point of BIS levels between 60-80 along with corresponding decrease in EMG scoring gives the best indicator for level of obstruction by improving chances of better surgical outcome after sleep surgery.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221914003 |
| Uncontrolled Keywords: | Drug Induced Sleep Endoscopy, Accordance, Depth of Sleep Measured, Bispectral Index, Obstructive Sleep Apnoea. |
| Subjects: | MEDICAL > Otolaryngology > MEDICAL > Otolaryngology |
| Depositing User: | Subramani R |
| Date Deposited: | 18 Apr 2022 10:01 |
| Last Modified: | 17 Dec 2023 03:13 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19348 |
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