Hemodynamics and oxygen saturation during intravenous sedation for office-based laser-assisted uvuloplasty

Purpose: Patients undergoing office-based laser-assisted uvuloplasty (LAUP) for snoring or mild obstructive sleep apnea are generally obese and have a high Mallampati score. Because avoidance of supplemental oxygen during laser procedures is generally mandated, the potential for intraoperative desaturation is high. This study was designed to look at intraoperative hemodynamic changes, respiration patterns, and oxygen saturations during intravenous sedation with midazolam and fentanyl during LAUP procedures. Materials and Methods: This was a retrospective anesthesia chart review of 15 consecutive patients undergoing midazolam/fentanyl intravenous sedation for office-based LAUP treatment for snoring and/or mild obstructive sleep apnea. Data recorded were noninvasive baseline and intraoperative hemodynamic measurements at 5-minute intervals for systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), pulse (P), and rate-pressure product (RPP). Data collected were reported as mean values with standard deviation. Statistical analysis using the Student's t test was performed and found significant for P <.05. Results: All changes from baseline were statistically insignificant, SBP (P =. 4), DBP (P =. 2), MAP (P =. 2), P (P =. 1), PP (P =. 9), RPP (P =. 5), RR (P =. 9), and SpO₂ (P =. 4), and all within ±20% of baseline (range, -5.0% to +7.5%). Conclusion: Midazolam and fentanyl intravenous sedation with local anesthesia maintained intraoperative hemodynamic and oxygenation variables close to baseline for office-based LAUP procedures.