Phasic Genioglossus and Palatoglossus Muscle Activity during Recovery from Sevoflurane Anesthesia

Srinivasan, Ilavajady; Strantzas, Samuel; Crawford, Mark W.

doi:10.1097/aln.0b013e318295a27b

Cited by 4 publications

(4 citation statements)

References 34 publications

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“…Airway endoscopy in children has also demonstrated that halothane causes dynamic changes of the upper airway and laryngeal inlet . Sevoflurane has dose‐dependent effects, with decreasing phasic inspiratory genioglossus activity seen with increasing depth of sevoflurane anesthesia and no difference in tonic activity . Sevoflurane can also decrease airway patency, especially during inspiration .…”

Section: Resultsmentioning

confidence: 99%

“…44 Sevoflurane has dose-dependent effects, with decreasing phasic inspiratory genioglossus activity seen with increasing depth of sevoflurane anesthesia and no difference in tonic activity. 45 Sevoflurane can also decrease airway patency, especially during inspiration. [46][47][48] In a study using both sevoflurane and nitrous oxide for induction and propofol for anesthesia maintenance, the greatest narrowing was seen at the soft palate level, and the airway dimensions changed when sedated versus awake.…”

Section: Resultsmentioning

confidence: 99%

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The effects of Anesthesia and opioids on the upper airway: A systematic review

Mahmoud²,

et al. 2015

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The effects of Anesthesia and opioids on the upper airway: A systematic review

Mahmoud²,

et al. 2015

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“…56 A study of sevoflurane demonstrated a dose-dependent effect on 2 of the major upper airway dilator muscles, the genioglossus and palatoglossus. 59 Litman et al reported decreased pharyngeal dilator muscle activity with halothane and sevoflurane, with sevoflurane causing relatively more upper airway obstruction. 60 Due to these concerns, the development group agreed that efforts should be made to minimize inhalation agent usage during pediatric DISE.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have also suggested exaggerated upper airway collapse with inhalational agents 56 . A study of sevoflurane demonstrated a dose‐dependent effect on 2 of the major upper airway dilator muscles, the genioglossus and palatoglossus 59 . Litman et al reported decreased pharyngeal dilator muscle activity with halothane and sevoflurane, with sevoflurane causing relatively more upper airway obstruction 60 .…”

Section: Discussionmentioning

confidence: 99%

Expert Consensus Statement: Pediatric Drug‐Induced Sleep Endoscopy

Baldassari

Lam

Ishman

et al. 2021

Otolaryngol.--head neck surg.

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Objective To develop an expert consensus statement on pediatric drug-induced sleep endoscopy (DISE) that clarifies controversies and offers opportunities for quality improvement. Pediatric DISE was defined as flexible endoscopy to examine the upper airway of a child with obstructive sleep apnea who is sedated and asleep. Methods Development group members with expertise in pediatric DISE followed established guidelines for developing consensus statements. A search strategist systematically reviewed the literature, and the best available evidence was used to compose consensus statements regarding DISE in children 0 to 18 years old. Topics with significant practice variation and those that would improve the quality of patient care were prioritized. Results The development group identified 59 candidate consensus statements, based on 50 initial proposed topics, that focused on addressing the following high-yield topics: (1) indications and utility, (2) protocol, (3) optimal sedation, (4) grading and interpretation, (5) complications and safety, and (6) outcomes for DISE-directed surgery. After 2 iterations of the Delphi survey and removal of duplicative statements, 26 statements met the criteria for consensus; 11 statements were designated as no consensus. Several areas, such as the role of DISE at the time of adenotonsillectomy, were identified as needing further research. Conclusion Expert consensus was achieved for 26 statements pertaining to indications, protocol, and outcomes for pediatric DISE. Clinicians can use these statements to improve quality of care, inform policy and protocols, and identify areas of uncertainty. Future research, ideally randomized controlled trials, is warranted to address additional controversies related to pediatric DISE.

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