Home E-Weekly August 5, 2014

Ramp Up To Manage Sleep Apnea

Published: August 4, 2014

A new, simplified approach to sedating patients with severe sleep apnea can help to identify potential airway obstructions before surgery, say University of Pennsylvania researchers.

According to a study published in the journal Anesthesia and Analgesia, the "ramp control" technique enabled the researchers to visualize and photograph obstructive anatomy in each of the 97 patients studied. The required level of sedation was reached in less than 4 minutes, and did not result in excessive lowering of blood oxygen levels, which remained at approximately 91%.

Drug-induced sleep endoscopy is typically used to assess airway anatomy, but requires up to 9 anesthetic doses, which can cause undue unconsciousness, the need for airway support and large drops in blood oxygenation. In contrast, ramping employs a computerized algorithm to calculate individualized 2-step dosing that will lightly sedate patients and reproduce apnea-causing obstructions. It's a simplified approach that the researchers say would make the technique more widespread.

"The effective sedation seen in this study with a low rate of desaturation and infrequent need for airway support is an important result," write the authors, although they say more research is needed before the technique is applied to everyday practice at busy surgery centers.

Daniel Cook

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