A COMPARATIVE STUDY OF PROPOFOL VERSUS PROPOFOL COMBINED WITH DEXMEDETOMIDINE IN DRUG-INDUCED SLEEP STUDIES

Background: Drug-induced sleep endoscopy (DISE) is a diagnostic procedure used to evaluate upper airway obstruction in patients with suspected obstructive sleep apnea (OSA). Propofol is the most commonly used agent; however, it may exaggerate airway collapse due to its muscle-relaxant properties. Dexmedetomidine, known for preserving upper airway tone, is being investigated in combination with propofol to improve the accuracy and safety of DISE. Aim: To compare the efficacy, airway dynamics, hemodynamic stability, and safety of propofol alone versus propofol combined with dexmedetomidine during DISE. Methods: A prospective randomized controlled study was conducted on 60 adult patients undergoing DISE. Patients were divided into two groups. Group P received intravenous propofol titrated to achieve a BIS of 60–80. Group PD received a dexmedetomidine bolus (1 mcg/kg over 10 minutes) followed by titrated propofol. Parameters studied included level and pattern of airway collapse, hemodynamic responses, sedation scores, adverse events, and recovery characteristics. Results: Both regimens provided adequate sedation. Group PD had improved visualization of airway structures and more stable hemodynamic parameters. There was a statistically significant reduction in complete concentric collapse at the level of the soft palate in Group PD compared to Group P. Recovery times were longer in the combination group. Patient satisfaction scores were higher in Group PD. Conclusion: The combination of dexmedetomidine and propofol offers superior airway visualization and hemodynamic stability compared to propofol alone, although recovery may be prolonged. It represents a safe and effective alternative in drug-induced sleep studies, especially in patients at risk for exaggerated airway collapse.