• Mohamed Mahmoud, Dorothy Jung, Shelia Salisbury, John McAuliffe, Joel Gunter, Mario Patio, Lane F Donnelly, and Robert Fleck.
• Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. Electronic address: mohamed.mahmoud@cchmc.org.
• J Clin Anesth. 2013 Nov 1;25(7):529-41.

Study ObjectiveTo examine the dose-response effects of dexmedetomidine (DEX) and propofol (PROP) on airway morphology in children and adolescents with a history of obstructive sleep apnea (OSA).DesignProspective, single-blinded, controlled comparative study.SettingUniversity-affiliated teaching hospital.Patients60 patients with a history of OSA who presented for a magnetic resonance imaging (MRI) sleep study.InterventionsPatients were randomized to two equal groups (DEX or PROP). Magnetic resonance images of the airway were obtained during low (1 μg/kg/hr) and high (3 μg/kg/hr) doses of DEX, or low (100 μg/kg/m) and high (200 μg/kg/m) doses of PROP, based on group assignment.MeasurementsThe airway anteroposterior (AP) diameter, transverse diameter, and sectional areas were measured at the level of the nasopharyngeal airway and retroglossal airway. The influence of the two drugs and OSA severity, as determined by polysomnography, on airway dimensions was examined using mixed-effects analysis of covariance models.Main ResultsUpper airway morphology was completed in 45 patients. Most airway measurements showed statistically nonsignificant associations with increasing doses of PROP and DEX. As the dosage increased, average airway dimensions were typically unchanged or slightly increased with DEX compared with airway dimensions that were unchanged or slightly decreased with PROP. An airway intervention was required in three children (11%) in the DEX group and 7 children (23%) in the PROP group (P = NS).ConclusionsBoth agents provided an acceptable level of anesthesia for MRI sleep studies in patients with OSA, with statistically nonsignificant changes in airway dimensions.© 2013 Elsevier Inc. All rights reserved.

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