Appendix - Lippincott Williams & Wilkins



AppendixTable A1: Studies evaluating the association between OSA and difficult airwayDifficulty airwaynTotalOSANon- OSASignificant Impact of OSA on difficulty airwayGRADELevel of evidenceYesNoDifficult mask ventilationPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaGV0ZXJwYWw8L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFy

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ADDIN EN.CITE.DATA 111Cross-sectional43Nocturnal arterial oxygen desaturationHypoxemia increased opioid analgesic effect-Increased3Khalid 2011 ADDIN EN.CITE <EndNote><Cite><Author>Khalid</Author><Year>2011</Year><RecNum>4407</RecNum><DisplayText><style face="superscript">110</style></DisplayText><record><rec-number>4407</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1502377957">4407</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Khalid, I.</author><author>Roehrs, T. A.</author><author>Hudgel, D. W.</author><author>Roth, T.</author></authors></contributors><auth-address>King Faisal Specialist Hospital &amp; Research Center, Jeddah, Saudi Arabia.</auth-address><titles><title>Continuous positive airway pressure in severe obstructive sleep apnea reduces pain sensitivity</title><secondary-title>Sleep</secondary-title><alt-title>Sleep</alt-title></titles><periodical><full-title>Sleep</full-title><abbr-1>Sleep</abbr-1><abbr-2>Sleep</abbr-2></periodical><alt-periodical><full-title>Sleep</full-title><abbr-1>Sleep</abbr-1><abbr-2>Sleep</abbr-2></alt-periodical><pages>1687-91</pages><volume>34</volume><number>12</number><edition>2011/12/02</edition><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>*Continuous Positive Airway Pressure</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Pain Measurement</keyword><keyword>*Pain Perception/physiology</keyword><keyword>Polysomnography</keyword><keyword>Sleep Apnea, Obstructive/physiopathology/*therapy</keyword><keyword>Young Adult</keyword><keyword>CPAP treatment</keyword><keyword>Pain sensitivity</keyword><keyword>obstructive sleep apnea syndrome</keyword></keywords><dates><year>2011</year><pub-dates><date>Dec 01</date></pub-dates></dates><isbn>0161-8105</isbn><accession-num>22131606</accession-num><urls></urls><custom2>PMC3208846</custom2><electronic-resource-num>10.5665/sleep.1436</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>110Prospective crossover comparison12CPAP, AHI, Sleep continuityCPAP reduced pain sensitivityIncreased-3Smith 2009PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TbWl0aDwvQXV0aG9yPjxZZWFyPjIwMDk8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 117Retrospective218Nocturnal arterial oxygen desaturation,Postoperative opioid consumptionHypoxemia increased opioid analgesic effect-Increased3Chung 2014 ADDIN EN.CITE <EndNote><Cite><Author>Chung</Author><Year>2014</Year><RecNum>2000</RecNum><DisplayText><style face="superscript">118</style></DisplayText><record><rec-number>2000</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1473542223">2000</key><key app="ENWeb" db-id="">0</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Chung, Frances</author><author>Liao, Pu</author><author>Yegneswaran, Balaji</author><author>Shapiro, Colin M</author><author>Kang, Weimin</author></authors></contributors><titles><title>Postoperative changes in sleep-disordered breathing and sleep architecture in patients with obstructive sleep apnea</title><secondary-title>Anesthesiology</secondary-title></titles><periodical><full-title>Anesthesiology</full-title><abbr-1>Anesthesiology</abbr-1><abbr-2>Anesthesiology</abbr-2></periodical><pages>287-98</pages><volume>120</volume><number>2</number><dates><year>2014</year></dates><isbn>0039-6206</isbn><urls><related-urls><url> SpO2No association between hypoxemia and opioid analgesic effect--3Sadhasivam 2012PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TYWRoYXNpdmFtPC9BdXRob3I+PFllYXI+MjAxMjwvWWVh

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ADDIN EN.CITE.DATA 114Prospective22Nocturnal arterial oxygen desaturationHypoxemia increased opioid analgesic effect-Increased3Brown 2004 ADDIN EN.CITE <EndNote><Cite><Author>Brown</Author><Year>2004</Year><RecNum>4349</RecNum><DisplayText><style face="superscript">113</style></DisplayText><record><rec-number>4349</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1502042366">4349</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Brown, K. A.</author><author>Laferriere, A.</author><author>Moss, I. R.</author></authors></contributors><auth-address>Division of Pediatric Anesthesia, McGill University Health Centre/Montreal Children&apos;s Hospital, Montreal, Quebec, Canada. roula.cacolyris@muhc.mcgill.ca</auth-address><titles><title>Recurrent hypoxemia in young children with obstructive sleep apnea is associated with reduced opioid requirement for analgesia</title><secondary-title>Anesthesiology</secondary-title><alt-title>Anesthesiology</alt-title></titles><periodical><full-title>Anesthesiology</full-title><abbr-1>Anesthesiology</abbr-1><abbr-2>Anesthesiology</abbr-2></periodical><alt-periodical><full-title>Anesthesiology</full-title><abbr-1>Anesthesiology</abbr-1><abbr-2>Anesthesiology</abbr-2></alt-periodical><pages>806-10; discussion 5A</pages><volume>100</volume><number>4</number><edition>2004/04/17</edition><keywords><keyword>Analgesics, Opioid/*administration &amp; dosage</keyword><keyword>Child, Preschool</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypoxia/*physiopathology</keyword><keyword>Infant</keyword><keyword>Male</keyword><keyword>Pain, Postoperative/*drug therapy</keyword><keyword>Recurrence</keyword><keyword>Sleep Apnea, Obstructive/*physiopathology</keyword></keywords><dates><year>2004</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>0003-3022 (Print)&#xD;0003-3022</isbn><accession-num>15087614</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>113Retrospective46Nocturnal arterial oxygen desaturationHypoxemia increased opioid analgesic effect-Increased3LOE: level of evidence, CPAP: continuous positive airway pressure, AHI: apnea-hypopnea index, PI: Primary insomnia, RDI: Respiratory disturbance indexTable A4: Propofol for Drug-Induced Sleep Endoscopy (DISE)StudyStudy designBiases/LimitationsNOutcomes/ConclusionsOxford LOEDeVito 2011PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EZSBWaXRvPC9BdXRob3I+PFllYXI+MjAxMTwvWWVhcj48

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ADDIN EN.CITE.DATA 121Propofol during PSG in non-OSA vs. OSA subjects.Prospective cross-sectionalNo difference in AHI and mean SpO2 between groups was used to infer that etiology of obstruction, and hence DISE findings, would not be affected by propofol.30Sleep architecture affected by propofol: Propofol PSG vs. non-propofol PSG subjects spent less time in N1 stage sleep (2.2 ± 2.5 vs. 28.4 ± 18.5, P <0.01), more time in N3 (43.1 ± 34.0 vs. 13.3 ± 13.5, P<0.01), and had total suppression of REM (0 vs. 10.6 ± 10.1, P<0.01). No significant differences between propofol vs. non-propofol PSG's for AHI (15.91 ± 20.91 vs. 16.75 ± 20.08, P= 0.72) or mean SpO2 (95.39 ± 1.66 vs. 95.67 ± 1.42, P= 0.17).3Dotan 2013 ADDIN EN.CITE <EndNote><Cite><Author>Dotan</Author><Year>2013</Year><RecNum>4521</RecNum><DisplayText><style face="superscript">122</style></DisplayText><record><rec-number>4521</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1509457909">4521</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dotan, Y.</author><author>Pillar, G.</author><author>Tov, N.</author><author>Oliven, R.</author><author>Steinfeld, U.</author><author>Gaitini, L.</author><author>Odeh, M.</author><author>Schwartz, A. R.</author><author>Oliven, A.</author></authors></contributors><auth-address>Dept of Internal Medicine, Bnai-Zion Medical Center, Technion, Israel.</auth-address><titles><title>Dissociation of electromyogram and mechanical response in sleep apnoea during propofol anaesthesia</title><secondary-title>Eur Respir J</secondary-title><alt-title>The European respiratory journal</alt-title></titles><periodical><full-title>European Respiratory Journal</full-title><abbr-1>Eur. Respir. J.</abbr-1><abbr-2>Eur Respir J</abbr-2></periodical><pages>74-84</pages><volume>41</volume><number>1</number><edition>2012/05/05</edition><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>*Anesthesia</keyword><keyword>Anesthetics, Intravenous/*pharmacology</keyword><keyword>Electromyography/*drug effects</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Propofol/*pharmacology</keyword><keyword>Sleep Apnea, Obstructive/*physiopathology</keyword></keywords><dates><year>2013</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>0903-1936</isbn><accession-num>22556023</accession-num><urls><related-urls><url> muscles and airway collapse during DISE.Prospective laboratory studyDosing basis (TBW, LBW, or ABW) not mentioned.17Under propofol, the response of pharyngeal dilator muscles to central neural activation was attenuated; genioglossus muscle was most affected.4Capasso 2016PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5DYXBhc3NvPC9BdXRob3I+PFllYXI+MjAxNjwvWWVhcj48

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ADDIN EN.CITE.DATA 123 DISE propofol vs. dexmedetomidine. Case series, chart reviewDosing basis (TBW, LBW, or ABW) not mentioned.216Propofol vs. dexmedetomidine group had a 75% vs. 42.7% rate of complete tongue base obstruction. Odds ratio: 4.0, 95% CI 2.0-8.1, P= 0.0001.4Kuyrukluyildiz et al. 2015PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LdXlydWtsdXlpbGRpejwvQXV0aG9yPjxZZWFyPjIwMTU8

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ADDIN EN.CITE.DATA 127 PK of propofol, dosed TBW vs. ABW.Data from 3 observation studiesNo randomization or blinding. Some obese, some normal weight, some undergoing surgery, some not.51Allometric size model (clearance modeled with an allometric 3/4 power, and distribution volume was calculated with a linear [exponent of 1] model) using TBW worked best. Dosing with ABW resulted in propofol concentrations consistently lower than target concentration.3Servin 1993 ADDIN EN.CITE <EndNote><Cite><Author>Servin</Author><Year>1993</Year><RecNum>4528</RecNum><DisplayText><style face="superscript">128</style></DisplayText><record><rec-number>4528</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1509458645">4528</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Servin, F.</author><author>Farinotti, R.</author><author>Haberer, J. P.</author><author>Desmonts, J. M.</author></authors></contributors><auth-address>Departement d&apos;Anesthesie-Reanimation, CHU Bichat-Claude Bernard, Paris, France.</auth-address><titles><title>Propofol infusion for maintenance of anesthesia in morbidly obese patients receiving nitrous oxide. A clinical and pharmacokinetic study</title><secondary-title>Anesthesiology</secondary-title><alt-title>Anesthesiology</alt-title></titles><periodical><full-title>Anesthesiology</full-title><abbr-1>Anesthesiology</abbr-1><abbr-2>Anesthesiology</abbr-2></periodical><alt-periodical><full-title>Anesthesiology</full-title><abbr-1>Anesthesiology</abbr-1><abbr-2>Anesthesiology</abbr-2></alt-periodical><pages>657-65</pages><volume>78</volume><number>4</number><edition>1993/04/01</edition><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>*Anesthesia, General</keyword><keyword>Drug Synergism</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Infusions, Intravenous</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Nitrous Oxide</keyword><keyword>Obesity, Morbid/*metabolism</keyword><keyword>Propofol/administration &amp; dosage/*pharmacokinetics</keyword></keywords><dates><year>1993</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>0003-3022 (Print)&#xD;0003-3022</isbn><accession-num>8466066</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>128MO dosed by ABW and nonobese by TBW. Two observation-al studies of propofol PK.No randomization or blinding. Some undergoing surgery, some not.18Total body clearance and volume at steady state correlated linearly with body weight in obese and controls, but distribution clearance did not. Context-sensitive half time (time required for the central compartment drug concentration at the end of infusion to decrease by 50%) was much faster than elimination half-life. Propofol dosage could be based upon TBW without risk of accumulation.4La Colla 2009PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5MYSBDb2xsYTwvQXV0aG9yPjxZZWFyPjIwMDk8L1llYXI+

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ADDIN EN.CITE.DATA 129Propofol TCI in MO, using ABW vs. TBW.Prospective, randomized, double-blindedNo mention of how many dosage adjustments were made because of cardiovascular or CNS pharmacodynamics.24Propofol blood levels lower than predicted in both groups, more so for the ABW group. Marsh TCI model may underestimate total body clearance and central volume of distribution at steady state, underdosing the patient, especially if ABW is used.2Dong 2016PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Eb25nPC9BdXRob3I+PFllYXI+MjAxNjwvWWVhcj48UmVj

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ADDIN EN.CITE.DATA 130Propofol dosed by TBW or LBW in MO; non-obese by TBW.RCTNon-obese controls were undergoing a different surgery, with more potential for underlying co-morbidity or intraoperative confounders, even though all were ASA I-II.29MO subjects had increased systemic clearance and peripheral compartment volume, resulting in a decreased propofol levels. Propofol maintenance infusion can be based on TBW in MO.2N: number of subjects, LOE: level of evidence, PK: pharmacokinetics, TBW: total body weight, ABW: adjusted body weight, MO: morbidly obese, TCI: target-controlled infusion, CNS: central nervous system, LBW: lean body weight, RCT: randomized controlled trial, ASA: American Society of Anesthesiologists’ physical status classificationTable A6: Adverse effects of propofol in patients with obstructive sleep apnea undergoing procedures with sedationStudyStudy DesignBiases/LimitationsNOutcomes/ConclusionsOxford LOEMehta 2014PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NZWh0YTwvQXV0aG9yPjxZZWFyPjIwMTQ8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 138STOP/BANG scores to predict complications during EGD or colonoscopy with propofol.ObservationalAI were left to the anesthesiologist's discretion without set criteria.243Incidence of AI and SRAE were not significantly different for S/B ≥3. AI and SRAE increased with BMI, age, loading dose of propofol, and smoking. 47.3% of all subjects required AI.3Coté 2010PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Db3RlPC9BdXRob3I+PFllYXI+MjAxMDwvWWVhcj48UmVj

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ADDIN EN.CITE.DATA 140Monitoring with vs. without capnography during colonoscopy with propofol.RCTMidazolam and/or ketamine used. Propofol dosing was not standardized. Anesthesia performed by either an anesthesiologist, nurse (not CRNA), or endoscopist-directed. 533SpO2 <90%: less often in the capnography group. Apnea or hypopnea was detected in 183 (69%) of the capnography group, and 23% of those patients developed hypoxemia. Risk factors for hypoxemia: age ≥ 55, obesity, OSA, total dose of propofol, and use of ketamine in addition to propofol.2Nagels 2014 ADDIN EN.CITE <EndNote><Cite><Author>Nagels</Author><Year>2014</Year><RecNum>4516</RecNum><DisplayText><style face="superscript">141</style></DisplayText><record><rec-number>4516</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1509457043">4516</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nagels, A. J.</author><author>Bridgman, J. B.</author><author>Bell, S. E.</author><author>Chrisp, D. J.</author></authors></contributors><titles><title>Propofol-remifentanil TCI sedation for oral surgery</title><secondary-title>N Z Dent J</secondary-title><alt-title>The New Zealand dental journal</alt-title></titles><periodical><full-title>New Zealand Dental Journal</full-title><abbr-1>N. Z. Dent. J.</abbr-1><abbr-2>N Z Dent J</abbr-2></periodical><pages>85-9</pages><volume>110</volume><number>3</number><edition>2014/10/01</edition><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/*administration &amp; dosage</keyword><keyword>Infusions, Intravenous</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Monitoring, Physiologic</keyword><keyword>New Zealand</keyword><keyword>Oxygen/blood</keyword><keyword>Patient Satisfaction</keyword><keyword>Piperidines/*administration &amp; dosage</keyword><keyword>Propofol/*administration &amp; dosage</keyword><keyword>Prospective Studies</keyword><keyword>Surveys and Questionnaires</keyword><keyword>*Tooth Extraction/nursing</keyword></keywords><dates><year>2014</year><pub-dates><date>Sep</date></pub-dates></dates><isbn>0028-8047 (Print)&#xD;0028-8047</isbn><accession-num>25265746</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>141Dentistry with propofol and remifentanil, monitored for oxygen desaturation events. Prospective observational studyComplexity of dental case (simple vs. surgical) not mentioned.150Oxygen desaturation events, defined as SpO2 < 94%, correlated with BMI and male gender. 3McVay 2017 ADDIN EN.CITE <EndNote><Cite><Author>McVay</Author><Year>2017</Year><RecNum>4537</RecNum><DisplayText><style face="superscript">143</style></DisplayText><record><rec-number>4537</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1509495232">4537</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McVay, Tyler</author><author>Fang, John C</author><author>Taylor, Linda</author><author>Au, Alexander</author><author>Williams, Wesley</author><author>Presson, Angela P</author><author>Al-Dulaimi, Ragheed</author><author>Volckmann, Eric</author><author>Ibele, Anna</author></authors></contributors><titles><title>Safety Analysis of Bariatric Patients Undergoing Outpatient Upper Endoscopy with Non-Anesthesia Administered Propofol Sedation</title><secondary-title>Obesity surgery</secondary-title></titles><periodical><full-title>Obesity Surgery</full-title><abbr-1>Obes. Surg.</abbr-1><abbr-2>Obes Surg</abbr-2></periodical><pages>1501-1507</pages><volume>27</volume><number>6</number><dates><year>2017</year></dates><isbn>0960-8923</isbn><urls></urls></record></Cite></EndNote>143Obese vs. non-obese, having EGD.RetrospectivePropofol used on all patients; opioids used at the nurse's discretion.395Obese subjects were more likely to have longer procedure times, episodes of SpO2 <90%, and need for airway interventions.3N: number of subjects, LOE: level of evidence, STOP/BANG: acronym of a proprietary sleep apnea screening tool, EGD: esophagogastroduodenoscopy, AI: airway interventions, SRAE: sedation-related adverse events, S/B: STOP/BANG, BMI: body mass index, SpO2: peripheral oxygen saturation, RCT: randomized controlled trial, CRNA: certified registered nurse anesthetist, OSA: obstructive sleep apneaTable A7: Comparative effectiveness of Inhalational agents and IV propofol in obesity - RCTsStudyNBMI kg/m2SurgeryOutcome/ConclusionEffect in favor ofOxfordLOEComparison: Propofol (TIVA) versus SevofluraneFassbenderPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GYXNzYmVuZGVyPC9BdXRob3I+PFllYXI+MjAxODwvWWVh

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ADDIN EN.CITE.DATA 1541994 4129.3 ± 5.1UPPP (OSA)Respiratory control recovery faster and lower pain with propofol.Propofol2Pizzirani ADDIN EN.CITE <EndNote><Cite><Author>Pizzirani</Author><Year>1992</Year><RecNum>4855</RecNum><DisplayText><style face="superscript">155</style></DisplayText><record><rec-number>4855</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516490915">4855</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Pizzirani, E.</author><author>Pigato, P.</author><author>Favretti, F.</author><author>Clemente, E.</author><author>Micaglio, M.</author><author>Lise, M.</author><author>Giron, G.</author></authors></contributors><auth-address>Departments of Anaesthesiology, University of Padua, Padua, 35121 Italy.</auth-address><titles><title>The Post-anaesthetic Recovery in Obesity Surgery: comparison between two anaesthetic techniques</title><secondary-title>Obes Surg</secondary-title><alt-title>Obesity surgery</alt-title></titles><periodical><full-title>Obesity Surgery</full-title><abbr-1>Obes. Surg.</abbr-1><abbr-2>Obes Surg</abbr-2></periodical><alt-periodical><full-title>Obesity Surgery</full-title><abbr-1>Obes. Surg.</abbr-1><abbr-2>Obes Surg</abbr-2></alt-periodical><pages>91-94</pages><volume>2</volume><number>1</number><edition>1992/02/01</edition><dates><year>1992</year><pub-dates><date>Feb</date></pub-dates></dates><isbn>0960-8923</isbn><accession-num>10765171</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>155 199240NABariatricAnesthesia recovery time shorter with propofol ( not stat. significant).Propofol2Comparison: Propofol (TIVA) versus DesfluraneTanakaPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UYW5ha2E8L0F1dGhvcj48WWVhcj4yMDE3PC9ZZWFyPjxS

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ADDIN EN.CITE.DATA 157 2011134 31 ± 3.5MinorImpaired lungfunction and oxygen saturation ↓with propofol; particualry with higher obesity.Desflurane2Comparison: Sevoflurane versus IsofluraneSollazziPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Tb2xsYXp6aTwvQXV0aG9yPjxZZWFyPjIwMDE8L1llYXI+

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ADDIN EN.CITE.DATA 158 200190>45BariatricExtubation time shorter and Aldtrete score ↑ in sevoflurane; no cardioresp. difference.Sevoflurane2TorriPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ub3JyaTwvQXV0aG9yPjxZZWFyPjIwMDE8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 159 200130>35BariatricFaster anesthesia recovery and PACU discharge with sevoflurane, no hemodynamic difference.Sevoflurane2Torri ADDIN EN.CITE <EndNote><Cite><Author>Torri</Author><Year>2002</Year><RecNum>4549</RecNum><DisplayText><style face="superscript">160</style></DisplayText><record><rec-number>4549</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1510689271">4549</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Torri, G</author><author>Casati, A</author><author>Comotti, L</author><author>Bignami, E</author><author>Santorsola, R</author><author>Scarioni, M</author></authors></contributors><titles><title>Wash-in and wash-out curves of sevoflurane and isoflurane in morbidly obese patients</title><secondary-title>Minerva anestesiologica</secondary-title></titles><periodical><full-title>Minerva Anestesiologica</full-title><abbr-1>Minerva Anestesiol.</abbr-1><abbr-2>Minerva Anestesiol</abbr-2></periodical><pages>523-527</pages><volume>68</volume><number>6</number><dates><year>2002</year></dates><isbn>0375-9393</isbn><urls></urls></record></Cite></EndNote>160 200214>35BariatricMore rapid wash-in and wash-out curves with sevoflurane.Sevoflurane2SudrePEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TdWRyZTwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 163 200650>35BariatricNo differences in anesthesia recovery.Neither2BilottaPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CaWxvdHRhPC9BdXRob3I+PFllYXI+MjAwOTwvWWVhcj48

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ADDIN EN.CITE.DATA 165 2016**84>40BariatricNo difference in hemodynamic and postoperaitve respiratory functions.Neither3StrumPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TdHJ1bTwvQXV0aG9yPjxZZWFyPjIwMDQ8L1llYXI+PFJl

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AG==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TdHJ1bTwvQXV0aG9yPjxZZWFyPjIwMDQ8L1llYXI+PFJl

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AG==

ADDIN EN.CITE.DATA 166 200450≥35BariatricFaster anesthesia recovery, aldrete score ↑, oxygen saturation ↑, PONV ↓ with desfluraneDesflurane2VallejoPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYWxsZWpvPC9BdXRob3I+PFllYXI+MjAwNzwvWWVhcj48

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ADDIN EN.CITE.DATA 168 20072850.6 ± 5.4BariatricFaster anesthesia recovery; faster wash-in and -out with desflurane. Desflurane2Kaur ADDIN EN.CITE <EndNote><Cite><Author>Kaur</Author><Year>2013</Year><RecNum>4553</RecNum><DisplayText><style face="superscript">169</style></DisplayText><record><rec-number>4553</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1511146465">4553</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kaur, A.</author><author>Jain, A. K.</author><author>Sehgal, R.</author><author>Sood, J.</author></authors></contributors><auth-address>Junior Intensivist, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.</auth-address><titles><title>Hemodynamics and early recovery characteristics of desflurane versus sevoflurane in bariatric surgery</title><secondary-title>J Anaesthesiol Clin Pharmacol</secondary-title><alt-title>Journal of anaesthesiology, clinical pharmacology</alt-title></titles><periodical><full-title>J Anaesthesiol Clin Pharmacol</full-title></periodical><pages>36-40</pages><volume>29</volume><number>1</number><edition>2013/03/16</edition><keywords><keyword>Anesthesia</keyword><keyword>anesthetics volatile</keyword><keyword>desflurane</keyword><keyword>early</keyword><keyword>intermediate</keyword><keyword>morbidly obese</keyword><keyword>recovery</keyword><keyword>sevoflurane</keyword></keywords><dates><year>2013</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>0970-9185 (Print)&#xD;0970-9185</isbn><accession-num>23493107</accession-num><urls></urls><custom2>PMC3590538</custom2><electronic-resource-num>10.4103/0970-9185.105792</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>169 20134049.23 ± 10.5BariatricFaster anesthesia recovery, Aldtere score ↑ with desflurane; no difference in hemodynamics.Desflurane2*Sevoflurane embedded in a short acting anesthesia regimen with remifentanil, rocuronium, ropivacaine. ** Observational studies.LOE: level of evidence, PACU: postoperative anesthesia care unit, PONV: postoperative nausea and vomiting, UPPP: uvulopalatopharyngoplastyTable A8: Comparative effectiveness of Inhalational agents, IV propofol and anesthesia monitoring in obesity – RCTsStudyNBMI kg/m2SurgeryConclusionEffect in favor ofOxfordLOEComparison: Propofol (TIVA) versus Desflurane, Isoflurane or SevofluraneJuvinPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5KdXZpbjwvQXV0aG9yPjxZZWFyPjIwMDA8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 170 20003646.5 ± 5.3BariatricFaster Anesthesia recovery, oxygen saturation ↑, sedation ↓, mobility ↑ with desflurane. Desflurane2Liu ADDIN EN.CITE <EndNote><Cite><Author>Liu</Author><Year>2015</Year><RecNum>4508</RecNum><DisplayText><style face="superscript">171</style></DisplayText><record><rec-number>4508</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1508303211">4508</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Liu, F. L.</author><author>Cherng, Y. G.</author><author>Chen, S. Y.</author><author>Su, Y. H.</author><author>Huang, S. Y.</author><author>Lo, P. H.</author><author>Lee, Y. Y.</author><author>Tam, K. W.</author></authors></contributors><auth-address>Department of Anesthesiology, Taipei Medical University - Shuang Ho Hospital, New Taipei City, Taiwan.</auth-address><titles><title>Postoperative recovery after anesthesia in morbidly obese patients: a systematic review and meta-analysis of randomized controlled trials</title><secondary-title>Can J Anaesth</secondary-title><alt-title>Canadian journal of anaesthesia = Journal canadien d&apos;anesthesie</alt-title></titles><periodical><full-title>Canadian Journal of Anaesthesia</full-title><abbr-1>Can. J. Anaesth.</abbr-1><abbr-2>Can J Anaesth</abbr-2></periodical><pages>907-17</pages><volume>62</volume><number>8</number><edition>2015/05/24</edition><keywords><keyword>Anesthesia Recovery Period</keyword><keyword>*Anesthesia, General</keyword><keyword>Anesthetics, Inhalation</keyword><keyword>Humans</keyword><keyword>Obesity, Morbid/*complications</keyword><keyword>Postoperative Nausea and Vomiting/epidemiology</keyword><keyword>Randomized Controlled Trials as Topic</keyword></keywords><dates><year>2015</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>0832-610x</isbn><accession-num>26001751</accession-num><urls></urls><electronic-resource-num>10.1007/s12630-015-0405-0</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>171 2015Meta-analysis (RCTs)11 RCTs37.7-54.0Various Faster anesthesia recovery with desflurane. Desflurane1BIS or AAI* monitoring for titration of anesthetic dosageIbraheimPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5JYnJhaGVpbTwvQXV0aG9yPjxZZWFyPjIwMDg8L1llYXI+

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ADDIN EN.CITE.DATA 220RCT66/64*Dex-Remifentanil Propofol (P) Propofol- Remifentanil (P-R) More patients had obstruction at oropharynx, tongue base and epiglottis, but did not reach significanceNo difference in airway obstruction scoresLower incidence of desaturations and higher mean SpO2 vs. P-R; no difference in desaturations or mean SpO2 vs. P; no difference in minimum SpO2RR < P at several time points; RR > P-R at 1 time pointNo difference in intra-procedural hypotension, bradycardia, arrhythmia; No difference in intra-procedural MAP, HR; Less cough vs. P, no difference vs. P-RUnclear2Kuyrukluyildiz 2015PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LdXlydWtsdXlpbGRpejwvQXV0aG9yPjxZZWFyPjIwMTU8

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ADDIN EN.CITE.DATA 124RCT40DexPropofolSpO2 higher intra- and post-procedure RR higher intra- and post-procedureMAP no difference intra-procedure, lower post-procedureHR no difference intra-procedure, lower post-procedureUnclear2Yoon 2016PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Zb29uPC9BdXRob3I+PFllYXI+MjAxNjwvWWVhcj48UmVj

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ADDIN EN.CITE.DATA 221Prospective, observational 50#DexPropofolNo difference in site or degree of obstruction% of patients with desaturations lower; mean minimal SpO2 higherMean HR lower, no difference in MAPLesser % of patients had > 20% change from baseline HR or BPUnclear3Chang 2017PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5DaGFuZzwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 222Systematic reviewSummary of conclusions: Dexmedetomidine appeared to provide greater cardiopulmonary stability. Benefits of propofol included faster onset and shorter half-life. When considering these DISE studies (plus data from other endoscopy studies), propofol seemed to induce greater airway obstruction and desaturations. In the context of DISE where the goal is to induce airway obstruction, propofol may be favored, but whether this obstruction reflects the obstruction during REM sleep is not established. 2Table A10: Studies using α-2 agonists (dexmedetomidine) in DISEcenter4806315* = n enrolled/ n analyzed; # = 50 individual patients underwent DISE on two consecutive days, first with propofol, then with dexmedetomidine. LOE: level of evidence Dex: Dexmedetomidine, P: Propofol, P-R: Propofol-Remifentanil, SpO2: peripheral oxygen saturation, RR: respiratory rate, MAP: mean arterial pressure, HR: heart rate, BP: blood pressure00* = n enrolled/ n analyzed; # = 50 individual patients underwent DISE on two consecutive days, first with propofol, then with dexmedetomidine. LOE: level of evidence Dex: Dexmedetomidine, P: Propofol, P-R: Propofol-Remifentanil, SpO2: peripheral oxygen saturation, RR: respiratory rate, MAP: mean arterial pressure, HR: heart rate, BP: blood pressureTable A11: Alpha-2 agonists and perioperative adverse events in OSA patientsStudyStudy designPatients (n)α-2 agonistComparison drugProcedureOutcome findings in α-2 agonist groupEffectOxfordLOEAirway and Respiratory EffectsAbdelmageed 2011 ADDIN EN.CITE <EndNote><Cite><Author>Abdelmageed</Author><Year>2011</Year><RecNum>4476</RecNum><DisplayText><style face="superscript">93</style></DisplayText><record><rec-number>4476</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1506151065">4476</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abdelmageed, W. M.</author><author>Elquesny, K. M.</author><author>Shabana, R. I.</author><author>Abushama, H. M.</author><author>Nassar, A. M.</author></authors></contributors><auth-address>Department of Anesthesia, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.</auth-address><titles><title>Analgesic properties of a dexmedetomidine infusion after uvulopalatopharyngoplasty in patients with obstructive sleep apnea</title><secondary-title>Saudi J Anaesth</secondary-title><alt-title>Saudi journal of anaesthesia</alt-title></titles><periodical><full-title>Saudi J Anaesth</full-title><abbr-1>Saudi journal of anaesthesia</abbr-1></periodical><alt-periodical><full-title>Saudi J Anaesth</full-title><abbr-1>Saudi journal of anaesthesia</abbr-1></alt-periodical><pages>150-6</pages><volume>5</volume><number>2</number><edition>2011/08/02</edition><keywords><keyword>Analgesics</keyword><keyword>dexmedetomidine</keyword><keyword>otolaryngological</keyword><keyword>pharmacology</keyword><keyword>postoperative</keyword><keyword>surgery</keyword></keywords><dates><year>2011</year><pub-dates><date>Apr</date></pub-dates></dates><accession-num>21804794</accession-num><urls></urls><custom2>PMC3139306</custom2><electronic-resource-num>10.4103/1658-354x.82782</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>93RCT43/39*DexPlaceboUvuloplastyLess respiratory depression, Higher mean RR and SpO2Not detrimental2Bamgbade 2009 ADDIN EN.CITE <EndNote><Cite><Author>Bamgbade</Author><Year>2009</Year><RecNum>4450</RecNum><DisplayText><style face="superscript">224</style></DisplayText><record><rec-number>4450</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1505415326">4450</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bamgbade, O. A.</author><author>Alfa, J. A.</author></authors></contributors><titles><title>Dexmedetomidine anaesthesia for patients with obstructive sleep apnoea undergoing bariatric surgery</title><secondary-title>Eur J Anaesthesiol</secondary-title><alt-title>European journal of anaesthesiology</alt-title></titles><periodical><full-title>European Journal of Anaesthesiology</full-title><abbr-1>Eur. J. Anaesthesiol.</abbr-1><abbr-2>Eur J Anaesthesiol</abbr-2></periodical><alt-periodical><full-title>European Journal of Anaesthesiology</full-title><abbr-1>Eur. J. Anaesthesiol.</abbr-1><abbr-2>Eur J Anaesthesiol</abbr-2></alt-periodical><pages>176-7</pages><volume>26</volume><number>2</number><edition>2009/01/15</edition><keywords><keyword>Adult</keyword><keyword>*Anesthesia</keyword><keyword>*Bariatric Surgery</keyword><keyword>Dexmedetomidine/*pharmacology</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Sleep Apnea, Obstructive</keyword></keywords><dates><year>2009</year><pub-dates><date>Feb</date></pub-dates></dates><isbn>0265-0215</isbn><accession-num>19142095</accession-num><urls><related-urls><url> Series22DexN/ALaparoscopic (lap) gastric bypassDescribed uneventful extubations, adequate saturations with supplemental oxygen, and no need for CPAP Not detrimental4Chawla 2010 ADDIN EN.CITE <EndNote><Cite><Author>Chawla</Author><Year>2010</Year><RecNum>4900</RecNum><DisplayText><style face="superscript">227</style></DisplayText><record><rec-number>4900</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548610">4900</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Chawla, S.</author><author>Robinson, S.</author><author>Norton, A.</author><author>Esterman, A.</author><author>Taneerananon, T.</author></authors></contributors><auth-address>Department of ENT, Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia. sharadch@</auth-address><titles><title>Peri-operative use of dexmedetomidine in airway reconstruction surgery for obstructive sleep apnoea</title><secondary-title>J Laryngol Otol</secondary-title></titles><periodical><full-title>Journal of Laryngology and Otology</full-title><abbr-1>J. Laryngol. Otol.</abbr-1><abbr-2>J Laryngol Otol</abbr-2><abbr-3>Journal of Laryngology &amp; Otology</abbr-3></periodical><pages>67-72</pages><volume>124</volume><number>1</number><keywords><keyword>Adult</keyword><keyword>Anesthesia, General/*methods</keyword><keyword>Blood Pressure</keyword><keyword>Case-Control Studies</keyword><keyword>Dexmedetomidine/*therapeutic use</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/*therapeutic use</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Otorhinolaryngologic Surgical Procedures/methods</keyword><keyword>Perioperative Care</keyword><keyword>Sleep Apnea, Obstructive/physiopathology/*surgery</keyword></keywords><dates><year>2010</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1748-5460 (Electronic)&#xD;0022-2151 (Linking)</isbn><accession-num>19852868</accession-num><urls><related-urls><url> DexAirway reconstruction surgery General statement that no interventions required for airway compromise in either groupNot detrimental3Dholakia 2007 ADDIN EN.CITE <EndNote><Cite><Author>Dholakia</Author><Year>2007</Year><RecNum>4898</RecNum><DisplayText><style face="superscript">225</style></DisplayText><record><rec-number>4898</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548609">4898</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dholakia, C.</author><author>Beverstein, G.</author><author>Garren, M.</author><author>Nemergut, C.</author><author>Boncyk, J.</author><author>Gould, J. C.</author></authors></contributors><auth-address>Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.</auth-address><titles><title>The impact of perioperative dexmedetomidine infusion on postoperative narcotic use and duration of stay after laparoscopic bariatric surgery</title><secondary-title>J Gastrointest Surg</secondary-title></titles><periodical><full-title>Journal of Gastrointestinal Surgery</full-title><abbr-1>J. Gastrointest. Surg.</abbr-1><abbr-2>J Gastrointest Surg</abbr-2></periodical><pages>1556-9</pages><volume>11</volume><number>11</number><keywords><keyword>Dexmedetomidine/*administration &amp; dosage</keyword><keyword>Female</keyword><keyword>*Gastric Bypass</keyword><keyword>*Gastroplasty</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/*administration &amp; dosage</keyword><keyword>Length of Stay</keyword><keyword>Male</keyword><keyword>Narcotics/*administration &amp; dosage</keyword><keyword>Perioperative Care</keyword><keyword>Postoperative Period</keyword><keyword>Retrospective Studies</keyword></keywords><dates><year>2007</year><pub-dates><date>Nov</date></pub-dates></dates><isbn>1091-255X (Print)&#xD;1091-255X (Linking)</isbn><accession-num>17710502</accession-num><urls><related-urls><url> DexLap gastric bypass; Lap gastric band No difference in initial PACU RR for both surgical groupsNot detrimental3Hannallah 2013 ADDIN EN.CITE <EndNote><Cite><Author>Hannallah</Author><Year>2013</Year><RecNum>4539</RecNum><DisplayText><style face="superscript">134</style></DisplayText><record><rec-number>4539</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1509495464">4539</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hannallah, Medhat</author><author>Rasmussen, Michael</author><author>Carroll, John</author><author>Charabaty, Aline</author><author>Palese, Caren</author><author>Haddad, Nadeem</author></authors></contributors><titles><title>Evaluation of dexmedetomidine/propofol anesthesia during upper gastrointestinal endoscopy in patients with high probability of having obstructive sleep apnea</title><secondary-title>Anaesthesia, Pain &amp; Intensive Care</secondary-title></titles><periodical><full-title>Anaesthesia, Pain &amp; Intensive Care</full-title></periodical><volume>17</volume><number>3</number><dates><year>2013</year></dates><isbn>1607-8322</isbn><urls></urls></record></Cite></EndNote>134Prospective case series20(7 w/ OSA)Dex + propofolN/AEndoscopyDescription that 13 patients required nasal trumpet, 2 patients required intervention for desaturationsUnclear4Issa 1992 ADDIN EN.CITE <EndNote><Cite><Author>Issa</Author><Year>1992</Year><RecNum>4901</RecNum><DisplayText><style face="superscript">228</style></DisplayText><record><rec-number>4901</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548610">4901</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Issa, F. G.</author></authors></contributors><auth-address>Faculty of Medicine, University of Calgary, Alberta, Canada.</auth-address><titles><title>Effect of clonidine in obstructive sleep apnea</title><secondary-title>Am Rev Respir Dis</secondary-title></titles><periodical><full-title>American Review of Respiratory Disease</full-title><abbr-1>Am. Rev. Respir. Dis.</abbr-1><abbr-2>Am Rev Respir Dis</abbr-2></periodical><pages>435-9</pages><volume>145</volume><number>2 Pt 1</number><keywords><keyword>Adult</keyword><keyword>Clonidine/*therapeutic use</keyword><keyword>Electrocardiography</keyword><keyword>Electroencephalography</keyword><keyword>Electromyography</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Oxygen/blood</keyword><keyword>Respiration</keyword><keyword>Sleep Apnea Syndromes/blood/*drug therapy/physiopathology</keyword><keyword>Sleep, REM/drug effects</keyword></keywords><dates><year>1992</year><pub-dates><date>Feb</date></pub-dates></dates><isbn>0003-0805 (Print)&#xD;0003-0805 (Linking)</isbn><accession-num>1736753</accession-num><urls><related-urls><url>, crossover8ClonidinePlacebo None (Sleep)Suppressed REM sleep, decreased apnea duration during REM sleep, no difference in AHI over entire sleep cycleDescribed varying effects on the breathing patterns and resulting obstructive events during REM sleepSmall differences in mean SpO2 and apnea duration assessed over entire sleep cycle (clincial significance unclear)Unclear2Jayaraman 2013 ADDIN EN.CITE <EndNote><Cite><Author>Jayaraman</Author><Year>2013</Year><RecNum>4903</RecNum><DisplayText><style face="superscript">233</style></DisplayText><record><rec-number>4903</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548611">4903</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Jayaraman, L.</author><author>Sinha, A.</author><author>Punhani, D.</author></authors></contributors><auth-address>Department of Anesthesia MAMBS, MAX Superspeciality Hospital, Saket, New Delhi, India.</auth-address><titles><title>A comparative study to evaluate the effect of intranasal dexmedetomidine versus oral alprazolam as a premedication agent in morbidly obese patients undergoing bariatric surgery</title><secondary-title>J Anaesthesiol Clin Pharmacol</secondary-title></titles><periodical><full-title>J Anaesthesiol Clin Pharmacol</full-title></periodical><pages>179-82</pages><volume>29</volume><number>2</number><keywords><keyword>Intranasal</keyword><keyword>dexmedetomidine</keyword><keyword>morbidly obese</keyword><keyword>obstructive sleep apnea</keyword><keyword>sedative premedication</keyword></keywords><dates><year>2013</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>0970-9185 (Print)&#xD;0970-9185 (Linking)</isbn><accession-num>23878437</accession-num><urls><related-urls><url> dex AlprazolamBariatric surgeryNo difference in preoperative SpO2Not detrimental2Ma 2012 ADDIN EN.CITE <EndNote><Cite><Author>Ma</Author><Year>2012</Year><RecNum>4897</RecNum><DisplayText><style face="superscript">223</style></DisplayText><record><rec-number>4897</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548609">4897</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ma, X. X.</author><author>Fang, X. M.</author><author>Hou, T. N.</author></authors></contributors><auth-address>Department of Anesthesiology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, China.</auth-address><titles><title>Comparison of the effectiveness of dexmedetomidine versus propofol target-controlled infusion for sedation during coblation-assisted upper airway procedure</title><secondary-title>Chin Med J (Engl)</secondary-title></titles><periodical><full-title>Chinese Medical Journal</full-title><abbr-1>Chin. Med. J. (Engl.)</abbr-1><abbr-2>Chin Med J (Engl)</abbr-2></periodical><pages>869-73</pages><volume>125</volume><number>5</number><keywords><keyword>Adult</keyword><keyword>Conscious Sedation/*methods</keyword><keyword>Dexmedetomidine/*therapeutic use</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/*therapeutic use</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Propofol/*therapeutic use</keyword></keywords><dates><year>2012</year><pub-dates><date>Mar</date></pub-dates></dates><isbn>0366-6999 (Print)&#xD;0366-6999 (Linking)</isbn><accession-num>22490589</accession-num><urls><related-urls><url> PropofolCoblation-assisted upper respiratory procedureLower incidence of desaturation, Higher SpO2 at most time points; RR higher at one time pointNot detrimental2Pawlik 2005PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5QYXdsaWs8L0F1dGhvcj48WWVhcj4yMDA1PC9ZZWFyPjxS

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ADDIN EN.CITE.DATA 229RCT30ClonidinePlaceboENT surgeryNo difference in AHI or desaturation index compared to placebo; minimal oxygen saturation significantly higher with clonidine on day of surgery; general statement at that no adverse respirarory events observedNot detrimental2Xu 2015 ADDIN EN.CITE <EndNote><Cite><Author>Xu</Author><Year>2015</Year><RecNum>4899</RecNum><DisplayText><style face="superscript">226</style></DisplayText><record><rec-number>4899</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548610">4899</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Xu, J.</author><author>Jin, C.</author><author>Cui, X.</author><author>Jin, Z.</author></authors></contributors><auth-address>Department of Anesthesiology, General Hospital of Shenyang Military Region, Shenyang, Liaoning, China (mainland).</auth-address><titles><title>Comparison of Dexmedetomidine versus Propofol for Sedation after Uvulopalatopharyngoplasty</title><secondary-title>Med Sci Monit</secondary-title></titles><periodical><full-title>Med Sci Monit</full-title><abbr-1>Medical science monitor : international medical journal of experimental and clinical research</abbr-1></periodical><pages>2125-33</pages><volume>21</volume><keywords><keyword>Adult</keyword><keyword>Conscious Sedation/*methods</keyword><keyword>Dexmedetomidine/*administration &amp; dosage/adverse effects</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/administration &amp; dosage/adverse effects</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Palate, Soft/*surgery</keyword><keyword>Pharynx/*surgery</keyword><keyword>Postoperative Care</keyword><keyword>Propofol/*administration &amp; dosage/adverse effects</keyword><keyword>Sleep Apnea, Obstructive/*surgery</keyword><keyword>Uvula/*surgery</keyword></keywords><dates><year>2015</year><pub-dates><date>Jul 22</date></pub-dates></dates><isbn>1643-3750 (Electronic)&#xD;1234-1010 (Linking)</isbn><accession-num>26200038</accession-num><urls><related-urls><url> respiratory depression; less coughing at extubation and coughing less severe; no patients in either group reintubatedNot detrimental2Hemodynamic EffectsAbdelmageed 2011 ADDIN EN.CITE <EndNote><Cite><Author>Abdelmageed</Author><Year>2011</Year><RecNum>4476</RecNum><DisplayText><style face="superscript">93</style></DisplayText><record><rec-number>4476</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1506151065">4476</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abdelmageed, W. M.</author><author>Elquesny, K. M.</author><author>Shabana, R. I.</author><author>Abushama, H. M.</author><author>Nassar, A. M.</author></authors></contributors><auth-address>Department of Anesthesia, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.</auth-address><titles><title>Analgesic properties of a dexmedetomidine infusion after uvulopalatopharyngoplasty in patients with obstructive sleep apnea</title><secondary-title>Saudi J Anaesth</secondary-title><alt-title>Saudi journal of anaesthesia</alt-title></titles><periodical><full-title>Saudi J Anaesth</full-title><abbr-1>Saudi journal of anaesthesia</abbr-1></periodical><alt-periodical><full-title>Saudi J Anaesth</full-title><abbr-1>Saudi journal of anaesthesia</abbr-1></alt-periodical><pages>150-6</pages><volume>5</volume><number>2</number><edition>2011/08/02</edition><keywords><keyword>Analgesics</keyword><keyword>dexmedetomidine</keyword><keyword>otolaryngological</keyword><keyword>pharmacology</keyword><keyword>postoperative</keyword><keyword>surgery</keyword></keywords><dates><year>2011</year><pub-dates><date>Apr</date></pub-dates></dates><accession-num>21804794</accession-num><urls></urls><custom2>PMC3139306</custom2><electronic-resource-num>10.4103/1658-354x.82782</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>93RCT43/39*DexPlaceboUvuloplastyGeneral statement that no hemodynamic differences, no interventions required for cardiovascular problems in either groupNot detrimental2Chawla 2010 ADDIN EN.CITE <EndNote><Cite><Author>Chawla</Author><Year>2010</Year><RecNum>4900</RecNum><DisplayText><style face="superscript">227</style></DisplayText><record><rec-number>4900</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548610">4900</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Chawla, S.</author><author>Robinson, S.</author><author>Norton, A.</author><author>Esterman, A.</author><author>Taneerananon, T.</author></authors></contributors><auth-address>Department of ENT, Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia. sharadch@</auth-address><titles><title>Peri-operative use of dexmedetomidine in airway reconstruction surgery for obstructive sleep apnoea</title><secondary-title>J Laryngol Otol</secondary-title></titles><periodical><full-title>Journal of Laryngology and Otology</full-title><abbr-1>J. Laryngol. Otol.</abbr-1><abbr-2>J Laryngol Otol</abbr-2><abbr-3>Journal of Laryngology &amp; Otology</abbr-3></periodical><pages>67-72</pages><volume>124</volume><number>1</number><keywords><keyword>Adult</keyword><keyword>Anesthesia, General/*methods</keyword><keyword>Blood Pressure</keyword><keyword>Case-Control Studies</keyword><keyword>Dexmedetomidine/*therapeutic use</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/*therapeutic use</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Otorhinolaryngologic Surgical Procedures/methods</keyword><keyword>Perioperative Care</keyword><keyword>Sleep Apnea, Obstructive/physiopathology/*surgery</keyword></keywords><dates><year>2010</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1748-5460 (Electronic)&#xD;0022-2151 (Linking)</isbn><accession-num>19852868</accession-num><urls><related-urls><url> No DexAirway reconstruction surgery Less use of rescue anti-hypertensives intraoperatively More patients with stable MAP (< 100 mmHg) postoperativelyGeneral statement describing transient loading dose HTN, followed by “titratable, controlled hypotension and bradycardia” intraoperativelyGeneral statement that there were no significant cardiovascular complications in either groupNot detrimental3Dholakia 2007 ADDIN EN.CITE <EndNote><Cite><Author>Dholakia</Author><Year>2007</Year><RecNum>4898</RecNum><DisplayText><style face="superscript">225</style></DisplayText><record><rec-number>4898</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548609">4898</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dholakia, C.</author><author>Beverstein, G.</author><author>Garren, M.</author><author>Nemergut, C.</author><author>Boncyk, J.</author><author>Gould, J. C.</author></authors></contributors><auth-address>Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.</auth-address><titles><title>The impact of perioperative dexmedetomidine infusion on postoperative narcotic use and duration of stay after laparoscopic bariatric surgery</title><secondary-title>J Gastrointest Surg</secondary-title></titles><periodical><full-title>Journal of Gastrointestinal Surgery</full-title><abbr-1>J. Gastrointest. Surg.</abbr-1><abbr-2>J Gastrointest Surg</abbr-2></periodical><pages>1556-9</pages><volume>11</volume><number>11</number><keywords><keyword>Dexmedetomidine/*administration &amp; dosage</keyword><keyword>Female</keyword><keyword>*Gastric Bypass</keyword><keyword>*Gastroplasty</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/*administration &amp; dosage</keyword><keyword>Length of Stay</keyword><keyword>Male</keyword><keyword>Narcotics/*administration &amp; dosage</keyword><keyword>Perioperative Care</keyword><keyword>Postoperative Period</keyword><keyword>Retrospective Studies</keyword></keywords><dates><year>2007</year><pub-dates><date>Nov</date></pub-dates></dates><isbn>1091-255X (Print)&#xD;1091-255X (Linking)</isbn><accession-num>17710502</accession-num><urls><related-urls><url> DexLap gastric bypass; Lap gastric band No difference in mean PACU HR or SBP for both surgical groupsNot detrimental3Feld 2006PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GZWxkPC9BdXRob3I+PFllYXI+MjAwNjwvWWVhcj48UmVj

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ADDIN EN.CITE.DATA 232RCT40Dex (5 w/ OSA)Fentanyl(6 w/ OSA)Lap gastric bandNo difference b/w MAP and HRNot detrimental2Hannallah 2013 ADDIN EN.CITE <EndNote><Cite><Author>Hannallah</Author><Year>2013</Year><RecNum>4539</RecNum><DisplayText><style face="superscript">134</style></DisplayText><record><rec-number>4539</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1509495464">4539</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hannallah, Medhat</author><author>Rasmussen, Michael</author><author>Carroll, John</author><author>Charabaty, Aline</author><author>Palese, Caren</author><author>Haddad, Nadeem</author></authors></contributors><titles><title>Evaluation of dexmedetomidine/propofol anesthesia during upper gastrointestinal endoscopy in patients with high probability of having obstructive sleep apnea</title><secondary-title>Anaesthesia, Pain &amp; Intensive Care</secondary-title></titles><periodical><full-title>Anaesthesia, Pain &amp; Intensive Care</full-title></periodical><volume>17</volume><number>3</number><dates><year>2013</year></dates><isbn>1607-8322</isbn><urls></urls></record></Cite></EndNote>134Prospective case series20(7 w/ OSA)Dex + propofolN/AEndoscopyTransient hypotension (SBP < 90 mmHg) requiring vasopressor use in 3 patients during procedure, 3 patients post-procedureUnclear4Jayaraman 2013 ADDIN EN.CITE <EndNote><Cite><Author>Jayaraman</Author><Year>2013</Year><RecNum>4903</RecNum><DisplayText><style face="superscript">233</style></DisplayText><record><rec-number>4903</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548611">4903</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Jayaraman, L.</author><author>Sinha, A.</author><author>Punhani, D.</author></authors></contributors><auth-address>Department of Anesthesia MAMBS, MAX Superspeciality Hospital, Saket, New Delhi, India.</auth-address><titles><title>A comparative study to evaluate the effect of intranasal dexmedetomidine versus oral alprazolam as a premedication agent in morbidly obese patients undergoing bariatric surgery</title><secondary-title>J Anaesthesiol Clin Pharmacol</secondary-title></titles><periodical><full-title>J Anaesthesiol Clin Pharmacol</full-title></periodical><pages>179-82</pages><volume>29</volume><number>2</number><keywords><keyword>Intranasal</keyword><keyword>dexmedetomidine</keyword><keyword>morbidly obese</keyword><keyword>obstructive sleep apnea</keyword><keyword>sedative premedication</keyword></keywords><dates><year>2013</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>0970-9185 (Print)&#xD;0970-9185 (Linking)</isbn><accession-num>23878437</accession-num><urls><related-urls><url> dex AlprazolamBariatric surgeryNo difference in preop HR, MAPNo difference in MAP at laryngoscopy, intubationLower HR at laryngoscopy, no difference at intubationUnclear2Ma 2012 ADDIN EN.CITE <EndNote><Cite><Author>Ma</Author><Year>2012</Year><RecNum>4897</RecNum><DisplayText><style face="superscript">223</style></DisplayText><record><rec-number>4897</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548609">4897</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ma, X. X.</author><author>Fang, X. M.</author><author>Hou, T. N.</author></authors></contributors><auth-address>Department of Anesthesiology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, China.</auth-address><titles><title>Comparison of the effectiveness of dexmedetomidine versus propofol target-controlled infusion for sedation during coblation-assisted upper airway procedure</title><secondary-title>Chin Med J (Engl)</secondary-title></titles><periodical><full-title>Chinese Medical Journal</full-title><abbr-1>Chin. Med. J. (Engl.)</abbr-1><abbr-2>Chin Med J (Engl)</abbr-2></periodical><pages>869-73</pages><volume>125</volume><number>5</number><keywords><keyword>Adult</keyword><keyword>Conscious Sedation/*methods</keyword><keyword>Dexmedetomidine/*therapeutic use</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/*therapeutic use</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Propofol/*therapeutic use</keyword></keywords><dates><year>2012</year><pub-dates><date>Mar</date></pub-dates></dates><isbn>0366-6999 (Print)&#xD;0366-6999 (Linking)</isbn><accession-num>22490589</accession-num><urls><related-urls><url> PropofolCoblation-assisted upper respiratory procedureLower MAP at one time pointLower HR at several time pointsNo difference in need for atropine/ephedrineLess need for rescue beta blockerUnclear2Pawlik 2005PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5QYXdsaWs8L0F1dGhvcj48WWVhcj4yMDA1PC9ZZWFyPjxS

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ADDIN EN.CITE.DATA 231RCT80/77*Dex (3 different doses)PlaceboBariatric SurgeryLower MAP at skin incision, no difference in HR; no difference in MAP at intubationMore patients in highest dose dex group required intraoperative phenylephrine, while more patients in control group required beta-blockerLower MAP, no difference in HR in PACUUnclear2Xu 2015 ADDIN EN.CITE <EndNote><Cite><Author>Xu</Author><Year>2015</Year><RecNum>4899</RecNum><DisplayText><style face="superscript">226</style></DisplayText><record><rec-number>4899</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548610">4899</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Xu, J.</author><author>Jin, C.</author><author>Cui, X.</author><author>Jin, Z.</author></authors></contributors><auth-address>Department of Anesthesiology, General Hospital of Shenyang Military Region, Shenyang, Liaoning, China (mainland).</auth-address><titles><title>Comparison of Dexmedetomidine versus Propofol for Sedation after Uvulopalatopharyngoplasty</title><secondary-title>Med Sci Monit</secondary-title></titles><periodical><full-title>Med Sci Monit</full-title><abbr-1>Medical science monitor : international medical journal of experimental and clinical research</abbr-1></periodical><pages>2125-33</pages><volume>21</volume><keywords><keyword>Adult</keyword><keyword>Conscious Sedation/*methods</keyword><keyword>Dexmedetomidine/*administration &amp; dosage/adverse effects</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/administration &amp; dosage/adverse effects</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Palate, Soft/*surgery</keyword><keyword>Pharynx/*surgery</keyword><keyword>Postoperative Care</keyword><keyword>Propofol/*administration &amp; dosage/adverse effects</keyword><keyword>Sleep Apnea, Obstructive/*surgery</keyword><keyword>Uvula/*surgery</keyword></keywords><dates><year>2015</year><pub-dates><date>Jul 22</date></pub-dates></dates><isbn>1643-3750 (Electronic)&#xD;1234-1010 (Linking)</isbn><accession-num>26200038</accession-num><urls><related-urls><url> and tachycardia less frequent, bradycardia more frequent, no difference in hypotension; lower BP and HR at extubation Unclear2Time to ExtubationAbdelmageed 2011 ADDIN EN.CITE <EndNote><Cite><Author>Abdelmageed</Author><Year>2011</Year><RecNum>4476</RecNum><DisplayText><style face="superscript">93</style></DisplayText><record><rec-number>4476</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1506151065">4476</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abdelmageed, W. M.</author><author>Elquesny, K. M.</author><author>Shabana, R. I.</author><author>Abushama, H. M.</author><author>Nassar, A. M.</author></authors></contributors><auth-address>Department of Anesthesia, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.</auth-address><titles><title>Analgesic properties of a dexmedetomidine infusion after uvulopalatopharyngoplasty in patients with obstructive sleep apnea</title><secondary-title>Saudi J Anaesth</secondary-title><alt-title>Saudi journal of anaesthesia</alt-title></titles><periodical><full-title>Saudi J Anaesth</full-title><abbr-1>Saudi journal of anaesthesia</abbr-1></periodical><alt-periodical><full-title>Saudi J Anaesth</full-title><abbr-1>Saudi journal of anaesthesia</abbr-1></alt-periodical><pages>150-6</pages><volume>5</volume><number>2</number><edition>2011/08/02</edition><keywords><keyword>Analgesics</keyword><keyword>dexmedetomidine</keyword><keyword>otolaryngological</keyword><keyword>pharmacology</keyword><keyword>postoperative</keyword><keyword>surgery</keyword></keywords><dates><year>2011</year><pub-dates><date>Apr</date></pub-dates></dates><accession-num>21804794</accession-num><urls></urls><custom2>PMC3139306</custom2><electronic-resource-num>10.4103/1658-354x.82782</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>93RCT43/39*DexPlaceboUvuloplastyLonger time to extubationDetrimental2Feld 2006PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GZWxkPC9BdXRob3I+PFllYXI+MjAwNjwvWWVhcj48UmVj

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ADDIN EN.CITE.DATA 231RCT80/77*Dex (3 different doses)PlaceboBariatric SurgeryNo differenceNot detrimental2Xu 2015 ADDIN EN.CITE <EndNote><Cite><Author>Xu</Author><Year>2015</Year><RecNum>4899</RecNum><DisplayText><style face="superscript">226</style></DisplayText><record><rec-number>4899</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548610">4899</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Xu, J.</author><author>Jin, C.</author><author>Cui, X.</author><author>Jin, Z.</author></authors></contributors><auth-address>Department of Anesthesiology, General Hospital of Shenyang Military Region, Shenyang, Liaoning, China (mainland).</auth-address><titles><title>Comparison of Dexmedetomidine versus Propofol for Sedation after Uvulopalatopharyngoplasty</title><secondary-title>Med Sci Monit</secondary-title></titles><periodical><full-title>Med Sci Monit</full-title><abbr-1>Medical science monitor : international medical journal of experimental and clinical research</abbr-1></periodical><pages>2125-33</pages><volume>21</volume><keywords><keyword>Adult</keyword><keyword>Conscious Sedation/*methods</keyword><keyword>Dexmedetomidine/*administration &amp; dosage/adverse effects</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/administration &amp; dosage/adverse effects</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Palate, Soft/*surgery</keyword><keyword>Pharynx/*surgery</keyword><keyword>Postoperative Care</keyword><keyword>Propofol/*administration &amp; dosage/adverse effects</keyword><keyword>Sleep Apnea, Obstructive/*surgery</keyword><keyword>Uvula/*surgery</keyword></keywords><dates><year>2015</year><pub-dates><date>Jul 22</date></pub-dates></dates><isbn>1643-3750 (Electronic)&#xD;1234-1010 (Linking)</isbn><accession-num>26200038</accession-num><urls><related-urls><url> time to extubationNot detrimental2Post-procedure SedationAbdelmageed 2011 ADDIN EN.CITE <EndNote><Cite><Author>Abdelmageed</Author><Year>2011</Year><RecNum>4476</RecNum><DisplayText><style face="superscript">93</style></DisplayText><record><rec-number>4476</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1506151065">4476</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abdelmageed, W. M.</author><author>Elquesny, K. M.</author><author>Shabana, R. I.</author><author>Abushama, H. M.</author><author>Nassar, A. M.</author></authors></contributors><auth-address>Department of Anesthesia, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.</auth-address><titles><title>Analgesic properties of a dexmedetomidine infusion after uvulopalatopharyngoplasty in patients with obstructive sleep apnea</title><secondary-title>Saudi J Anaesth</secondary-title><alt-title>Saudi journal of anaesthesia</alt-title></titles><periodical><full-title>Saudi J Anaesth</full-title><abbr-1>Saudi journal of anaesthesia</abbr-1></periodical><alt-periodical><full-title>Saudi J Anaesth</full-title><abbr-1>Saudi journal of anaesthesia</abbr-1></alt-periodical><pages>150-6</pages><volume>5</volume><number>2</number><edition>2011/08/02</edition><keywords><keyword>Analgesics</keyword><keyword>dexmedetomidine</keyword><keyword>otolaryngological</keyword><keyword>pharmacology</keyword><keyword>postoperative</keyword><keyword>surgery</keyword></keywords><dates><year>2011</year><pub-dates><date>Apr</date></pub-dates></dates><accession-num>21804794</accession-num><urls></urls><custom2>PMC3139306</custom2><electronic-resource-num>10.4103/1658-354x.82782</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>93RCT43/39*DexPlaceboUvuloplastyNo difference in postoperative sedation scoresNot detrimental2Hannallah 2013 ADDIN EN.CITE <EndNote><Cite><Author>Hannallah</Author><Year>2013</Year><RecNum>4539</RecNum><DisplayText><style face="superscript">134</style></DisplayText><record><rec-number>4539</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1509495464">4539</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hannallah, Medhat</author><author>Rasmussen, Michael</author><author>Carroll, John</author><author>Charabaty, Aline</author><author>Palese, Caren</author><author>Haddad, Nadeem</author></authors></contributors><titles><title>Evaluation of dexmedetomidine/propofol anesthesia during upper gastrointestinal endoscopy in patients with high probability of having obstructive sleep apnea</title><secondary-title>Anaesthesia, Pain &amp; Intensive Care</secondary-title></titles><periodical><full-title>Anaesthesia, Pain &amp; Intensive Care</full-title></periodical><volume>17</volume><number>3</number><dates><year>2013</year></dates><isbn>1607-8322</isbn><urls></urls></record></Cite></EndNote>134Prospective case series20(7 w/ OSA)Dex + propofolN/AEndoscopyDescribed prolonged sedation as main reason for discharge delay; 16 pts reported drowsiness after dischargeDetrimental4Postoperative Nausea and VomitingAbdelmageed 2011 ADDIN EN.CITE <EndNote><Cite><Author>Abdelmageed</Author><Year>2011</Year><RecNum>4476</RecNum><DisplayText><style face="superscript">93</style></DisplayText><record><rec-number>4476</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1506151065">4476</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abdelmageed, W. M.</author><author>Elquesny, K. M.</author><author>Shabana, R. I.</author><author>Abushama, H. M.</author><author>Nassar, A. M.</author></authors></contributors><auth-address>Department of Anesthesia, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.</auth-address><titles><title>Analgesic properties of a dexmedetomidine infusion after uvulopalatopharyngoplasty in patients with obstructive sleep apnea</title><secondary-title>Saudi J Anaesth</secondary-title><alt-title>Saudi journal of anaesthesia</alt-title></titles><periodical><full-title>Saudi J Anaesth</full-title><abbr-1>Saudi journal of anaesthesia</abbr-1></periodical><alt-periodical><full-title>Saudi J Anaesth</full-title><abbr-1>Saudi journal of anaesthesia</abbr-1></alt-periodical><pages>150-6</pages><volume>5</volume><number>2</number><edition>2011/08/02</edition><keywords><keyword>Analgesics</keyword><keyword>dexmedetomidine</keyword><keyword>otolaryngological</keyword><keyword>pharmacology</keyword><keyword>postoperative</keyword><keyword>surgery</keyword></keywords><dates><year>2011</year><pub-dates><date>Apr</date></pub-dates></dates><accession-num>21804794</accession-num><urls></urls><custom2>PMC3139306</custom2><electronic-resource-num>10.4103/1658-354x.82782</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>93RCT43/39*DexPlaceboUvuloplastyLess nausea/vomitingNot detrimental2Dholakia 2007 ADDIN EN.CITE <EndNote><Cite><Author>Dholakia</Author><Year>2007</Year><RecNum>4898</RecNum><DisplayText><style face="superscript">225</style></DisplayText><record><rec-number>4898</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548609">4898</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dholakia, C.</author><author>Beverstein, G.</author><author>Garren, M.</author><author>Nemergut, C.</author><author>Boncyk, J.</author><author>Gould, J. C.</author></authors></contributors><auth-address>Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.</auth-address><titles><title>The impact of perioperative dexmedetomidine infusion on postoperative narcotic use and duration of stay after laparoscopic bariatric surgery</title><secondary-title>J Gastrointest Surg</secondary-title></titles><periodical><full-title>Journal of Gastrointestinal Surgery</full-title><abbr-1>J. Gastrointest. Surg.</abbr-1><abbr-2>J Gastrointest Surg</abbr-2></periodical><pages>1556-9</pages><volume>11</volume><number>11</number><keywords><keyword>Dexmedetomidine/*administration &amp; dosage</keyword><keyword>Female</keyword><keyword>*Gastric Bypass</keyword><keyword>*Gastroplasty</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/*administration &amp; dosage</keyword><keyword>Length of Stay</keyword><keyword>Male</keyword><keyword>Narcotics/*administration &amp; dosage</keyword><keyword>Perioperative Care</keyword><keyword>Postoperative Period</keyword><keyword>Retrospective Studies</keyword></keywords><dates><year>2007</year><pub-dates><date>Nov</date></pub-dates></dates><isbn>1091-255X (Print)&#xD;1091-255X (Linking)</isbn><accession-num>17710502</accession-num><urls><related-urls><url> DexLap gastric bypass; Lap gastric band No difference in antiemetic dose in gastric bypass; Less antiemetic dose in gastric bandNot detrimental3Tufanogullari 2008PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UdWZhbm9ndWxsYXJpPC9BdXRob3I+PFllYXI+MjAwODwv

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ADDIN EN.CITE.DATA 231RCT80Dex (3 different doses)PlaceboBariatric SurgeryLess nausea/vomiting; lower incidence of need for rescue antiemeticNot detrimental2Xu 2015 ADDIN EN.CITE <EndNote><Cite><Author>Xu</Author><Year>2015</Year><RecNum>4899</RecNum><DisplayText><style face="superscript">226</style></DisplayText><record><rec-number>4899</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1516548610">4899</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Xu, J.</author><author>Jin, C.</author><author>Cui, X.</author><author>Jin, Z.</author></authors></contributors><auth-address>Department of Anesthesiology, General Hospital of Shenyang Military Region, Shenyang, Liaoning, China (mainland).</auth-address><titles><title>Comparison of Dexmedetomidine versus Propofol for Sedation after Uvulopalatopharyngoplasty</title><secondary-title>Med Sci Monit</secondary-title></titles><periodical><full-title>Med Sci Monit</full-title><abbr-1>Medical science monitor : international medical journal of experimental and clinical research</abbr-1></periodical><pages>2125-33</pages><volume>21</volume><keywords><keyword>Adult</keyword><keyword>Conscious Sedation/*methods</keyword><keyword>Dexmedetomidine/*administration &amp; dosage/adverse effects</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/administration &amp; dosage/adverse effects</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Palate, Soft/*surgery</keyword><keyword>Pharynx/*surgery</keyword><keyword>Postoperative Care</keyword><keyword>Propofol/*administration &amp; dosage/adverse effects</keyword><keyword>Sleep Apnea, Obstructive/*surgery</keyword><keyword>Uvula/*surgery</keyword></keywords><dates><year>2015</year><pub-dates><date>Jul 22</date></pub-dates></dates><isbn>1643-3750 (Electronic)&#xD;1234-1010 (Linking)</isbn><accession-num>26200038</accession-num><urls><related-urls><url> difference in nausea/vomitingNot detrimental2 -428624520249* = n enrolled/ n analyzed; # Dholakia et al. analyzed gastric bypass (Dex n = 23, no Dex = 19) and gastric band (Dex n = 11, no Dex n = 18) patients separately. LOE: level of evidence, Dex: Dexmedetomidine, PACU: postoperative anesthesia care unit, UPPP: uvulopalatopharyngoplasty, SpO2: peripheral oxygen saturation, HTN: hypertension, BP: blood pressure, SBP: systolic blood pressure, MAP: mean arterial pressure, RR: respiratory rate, CPAP: continuous positive airway pressure, pts: patients00* = n enrolled/ n analyzed; # Dholakia et al. analyzed gastric bypass (Dex n = 23, no Dex = 19) and gastric band (Dex n = 11, no Dex n = 18) patients separately. LOE: level of evidence, Dex: Dexmedetomidine, PACU: postoperative anesthesia care unit, UPPP: uvulopalatopharyngoplasty, SpO2: peripheral oxygen saturation, HTN: hypertension, BP: blood pressure, SBP: systolic blood pressure, MAP: mean arterial pressure, RR: respiratory rate, CPAP: continuous positive airway pressure, pts: patientsTable A12: Anesthesia techniqueStudyStudy designPatients (N) SurgeryOutcomesConclusionEffect of general anesthesiaOxfordLOEAnesthesia technique as a modifier of postoperative outcomeAmbrosii 2016 ADDIN EN.CITE <EndNote><Cite><Author>Ambrosii</Author><Year>2016</Year><RecNum>4485</RecNum><DisplayText><style face="superscript">236</style></DisplayText><record><rec-number>4485</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1507179621">4485</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ambrosii, T.</author><author>Sandru, S.</author><author>Belii, A.</author></authors></contributors><auth-address>State University of Medicine and Pharmacy &quot;Nicolae Testemitanu&quot;, Republic of Moldova.</auth-address><titles><title>The prevalence of perioperative complications in patients with and without obstructive sleep apnoea: a prospective cohort study</title><secondary-title>Rom J Anaesth Intensive Care</secondary-title><alt-title>Romanian journal of anaesthesia and intensive care</alt-title></titles><periodical><full-title>Rom J Anaesth Intensive Care</full-title><abbr-1>Romanian journal of anaesthesia and intensive care</abbr-1></periodical><alt-periodical><full-title>Rom J Anaesth Intensive Care</full-title><abbr-1>Romanian journal of anaesthesia and intensive care</abbr-1></alt-periodical><pages>103-110</pages><volume>23</volume><number>2</number><edition>2017/09/16</edition><keywords><keyword>obstructive sleep apnoea</keyword><keyword>postoperative complications</keyword></keywords><dates><year>2016</year><pub-dates><date>Oct</date></pub-dates></dates><isbn>2392-7518 (Print)&#xD;2392-7518</isbn><accession-num>28913483</accession-num><urls></urls><custom2>PMC5505383</custom2><electronic-resource-num>10.21454/rjaic.7518/232.pec</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>236 Observational/prospective400Orthopedic, abdominalPost-operative complicationsGeneral anesthesia associated with higher risk for complicationsadverse4Liu 2009PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5MaXU8L0F1dGhvcj48WWVhcj4yMDA5PC9ZZWFyPjxSZWNO

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ADDIN EN.CITE.DATA 237 Observational/prospective 653UPPPPostoperative complicationsGeneral anesthesia associated with higher risk for complicationsadverse3Liu SS 2011 ADDIN EN.CITE <EndNote><Cite><Author>Liu</Author><Year>2011</Year><RecNum>514</RecNum><DisplayText><style face="superscript">238</style></DisplayText><record><rec-number>514</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1443149677">514</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Liu, S. S.</author><author>Chisholm, M. F.</author><author>Ngeow, J.</author><author>John, R. S.</author><author>Shaw, P.</author><author>Ma, Y.</author><author>Memtsoudis, S. G.</author></authors></contributors><titles><title>Postoperative hypoxemia in orthopedic patients with obstructive sleep apnea</title><secondary-title>HSS J</secondary-title></titles><periodical><full-title>HSS J</full-title></periodical><pages>2-8</pages><volume>7</volume><number>1</number><keywords><keyword>hypoxemia</keyword><keyword>obstructive sleep apnea</keyword><keyword>orthopedic surgery</keyword><keyword>postoperative complications</keyword></keywords><dates><year>2011</year><pub-dates><date>Feb</date></pub-dates></dates><isbn>1556-3324 (Electronic)&#xD;1556-3316 (Linking)</isbn><accession-num>22294951</accession-num><urls><related-urls><url> Observational/retrospective 527OrthopedicPostoperative complicationsGeneral anesthesiaassociated with higher risk for hypoxemiaadverse3Memtsoudis 2013PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NZW10c291ZGlzPC9BdXRob3I+PFllYXI+MjAxMzwvWWVh

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ADDIN EN.CITE.DATA 239 Observational/retrospective 4,984TJAPostoperativecomplicationsGeneral anesthesia associated with higher risk for complicationsadverse2Ramachandran 2017 ADDIN EN.CITE <EndNote><Cite><Author>Ramachandran</Author><Year>2017</Year><RecNum>4284</RecNum><DisplayText><style face="superscript">61</style></DisplayText><record><rec-number>4284</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1501336378">4284</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ramachandran, S. K.</author><author>Pandit, J.</author><author>Devine, S.</author><author>Thompson, A.</author><author>Shanks, A.</author></authors></contributors><auth-address>From the *Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School at Beth Israel Deaconess Medical Center, Harvard University, Boston, Massachusetts; daggerNuffield Department of Anaesthesia, University of Oxford, Oxford, United Kingdom; and double daggerCenter for Observational &amp; Real World Evidence, Merck, Sharpe and Dohme, Whitehouse Station, New Jersey.</auth-address><titles><title>Postoperative Respiratory Complications in Patients at Risk for Obstructive Sleep Apnea: A Single-Institution Cohort Study</title><secondary-title>Anesth Analg</secondary-title><alt-title>Anesthesia and analgesia</alt-title></titles><periodical><full-title>Anesthesia and Analgesia</full-title><abbr-1>Anesth. Analg.</abbr-1><abbr-2>Anesth Analg</abbr-2><abbr-3>Anesthesia &amp; Analgesia</abbr-3></periodical><alt-periodical><full-title>Anesthesia and Analgesia</full-title><abbr-1>Anesth. Analg.</abbr-1><abbr-2>Anesth Analg</abbr-2><abbr-3>Anesthesia &amp; Analgesia</abbr-3></alt-periodical><pages>272-279</pages><volume>125</volume><number>1</number><edition>2017/06/18</edition><dates><year>2017</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>0003-2999</isbn><accession-num>28622177</accession-num><urls></urls><electronic-resource-num>10.1213/ane.0000000000002132</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>61 Observational/retrospective 108,479VariousPostoperative respiratory complicationsIn general anesthesia, OSA a predictor of complicationsadverse3Deterioration of sleep disordered breathingChung 2014 ADDIN EN.CITE <EndNote><Cite><Author>Chung</Author><Year>2014</Year><RecNum>556</RecNum><DisplayText><style face="superscript">79</style></DisplayText><record><rec-number>556</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1444159228">556</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Chung, Frances</author><author>Liao, Pu</author><author>Elsaid, Hisham</author><author>Shapiro, Colin M</author><author>Kang, Weimin</author></authors></contributors><titles><title>Factors associated with postoperative exacerbation of sleep-disordered breathing</title><secondary-title>Anesthesiology</secondary-title></titles><periodical><full-title>Anesthesiology</full-title><abbr-1>Anesthesiology</abbr-1><abbr-2>Anesthesiology</abbr-2></periodical><pages>299-311</pages><volume>120</volume><number>2</number><dates><year>2014</year></dates><isbn>0039-6206</isbn><urls><related-urls><url> 376VariousApnea-Hypopnea Index Central Apnea IndexGeneral anesthesia associated with increased central apnea indexadverse3Residual neuromuscular blockade and general anesthesiaPereira 2013PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5QZXJlaXJhPC9BdXRob3I+PFllYXI+MjAxMzwvWWVhcj48

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ADDIN EN.CITE.DATA 242Observational/prospective108VariousResidual neuromuscular blockadeHigher incidence of residual neuromuscular blockade in OSAadverse3Pre- and postoperative airway management complicationsBiddle 1996 ADDIN EN.CITE <EndNote><Cite><Author>Biddle</Author><Year>1996</Year><RecNum>4489</RecNum><DisplayText><style face="superscript">240</style></DisplayText><record><rec-number>4489</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1507255736">4489</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Biddle, C.</author></authors></contributors><auth-address>Department of Anesthesiology, Dartmouth Medical School, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.</auth-address><titles><title>Comparative aspects of the airway during general anesthesia in obese sufferers of sleep apnea and matched normals</title><secondary-title>Adv Pract Nurs Q</secondary-title><alt-title>Advanced practice nursing quarterly</alt-title></titles><periodical><full-title>Advanced Practice Nursing Quarterly</full-title><abbr-1>Adv. Pract. Nurs. Q.</abbr-1><abbr-2>Adv Pract Nurs Q</abbr-2></periodical><alt-periodical><full-title>Advanced Practice Nursing Quarterly</full-title><abbr-1>Adv. Pract. Nurs. Q.</abbr-1><abbr-2>Adv Pract Nurs Q</abbr-2></alt-periodical><pages>14-9</pages><volume>2</volume><number>3</number><edition>1996/01/01</edition><keywords><keyword>Adult</keyword><keyword>Airway Obstruction/*diagnosis</keyword><keyword>*Anesthesia</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Obesity/*complications</keyword><keyword>Sleep Apnea Syndromes/*complications</keyword></keywords><dates><year>1996</year><pub-dates><date>Winter</date></pub-dates></dates><isbn>1080-4293 (Print)&#xD;1080-4293</isbn><accession-num>9447084</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>240Observational/prospective 76VariousAirway management complicationsAirway management complications more frequent in OSAadverse3Loube 1997 ADDIN EN.CITE <EndNote><Cite><Author>Loube</Author><Year>1997</Year><RecNum>4490</RecNum><DisplayText><style face="superscript">241</style></DisplayText><record><rec-number>4490</rec-number><foreign-keys><key app="EN" db-id="aaxpdpw525rfavedptrvsp0reat9xzr5xzv5" timestamp="1507259132">4490</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Loube, D. I.</author><author>Erman, M. K.</author><author>Reed, W.</author></authors></contributors><auth-address>Pulmonary and Critical Care Medicine Service, Army Medical Center, 20307-5001, Washington D.C..</auth-address><titles><title>Perioperative complications in obstructive sleep apnea patients</title><secondary-title>Sleep Breath</secondary-title><alt-title>Sleep &amp; breathing = Schlaf &amp; Atmung</alt-title></titles><periodical><full-title>Sleep Breath</full-title><abbr-1>Sleep and Breathing</abbr-1></periodical><pages>3-10</pages><volume>2</volume><number>1</number><edition>1997/03/01</edition><dates><year>1997</year><pub-dates><date>Mar</date></pub-dates></dates><isbn>1520-9512 (Print)&#xD;1520-9512</isbn><accession-num>19412709</accession-num><urls></urls><electronic-resource-num>10.1007/bf03038852</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>241Observational/retrospective 48UPPPAirway management complicationsAirway management complications more frequent in OSAadverse3LOE: level of evidence, THA: total hip arthroplasty, TKA: total knee arthroplasty, TJA: total joint arthroplasty, UPPP: uvulopalatopharyngoplasty, LOS: length of stay ................
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