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Introduction: There are currently no specific anesthetic guidelines for patients with obstructive sleep apnea (OSA) undergoing upper airway surgery. Two consistently utilized anesthetic approaches during such procedures include inhalational gas anesthesia and total intravenous anesthesia (TIVA), however whether either is more efficacious remains undefined. We hypothesize that administration of TIVA will lead to reduced post-operative recovery time in patients with comorbid OSA undergoing upper airway surgery.

Methods: A retrospective chart review was performed for patients with comorbid OSA that underwent surgery (upper airway stimulation, nasal surgery, palate surgery) between January 2019 and December 2019. Included patients received either inhaled anesthesia or TIVA, and were assessed for time spent in Phase I (main re-stabilization phase) of post-operative recovery. Calculated times were compared using unpaired non-parametric Mann Whitney U tests.

Results: Collectively, 86 patients received inhaled anesthesia and 62 patients received TIVA. Phase I times were lessened following the use of TIVA as opposed to inhaled anesthesia when patients were stratified by surgery type. Upper airway stimulation, nasal surgery, and palate surgery patients experienced Phase I time decreases of 42.5 minutes (P < 0.001), 35.5 minutes (P < 0.001), and 36 minutes (P = 0.02), respectively.

Discussion: Patients with comorbid OSA experienced significantly reduced time spent in the main phase of post-operative recovery after receiving TIVA, supporting our hypothesis. This study sheds light on potential benefits of TIVA as an anesthetic approach to surgical patients with OSA. Further study is necessary to support this patient population by expanding upon these findings.