Shao Liu-Jia-Zi, Hong Fang-Xiao, Liu Fu-Kun, Wan Lei, Xue Fu-Shan
Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
World J Clin Cases. 2021 Jul 16;9(20):5479-5489. doi: 10.12998/wjcc.v9.i20.5479.
Hypoxemia is a common complication in obese patients during gastroscopy with sedation. The Wei nasal jet tube (WNJT) is a new special nasopharyngeal airway with the ability to provide supraglottic jet ventilation and oxygen insufflation its built-in wall channels. The aim of this study was to compare the efficacy and safety of the WNJT a nasal cannula for supplemental oxygen during gastroscopy with propofol mono-sedation in obese patients.
To compare the efficacy and safety of the WNJT a nasal cannula for supplemental oxygen during gastroscopy with propofol mono-sedation in obese patients.
A total of 103 obese patients with a body mass index of 30 kg/m or more undergoing elective gastroscopy under propofol mono-sedation were randomly assigned to receive supplemental oxygen at 5 L/min through either a WNJT (WNJT group, = 51) or a nasal cannula (nasal cannula group, = 52). The lowest pulse oxygen saturation (SpO) and mild and severe hypoxemia during gastroscopy were recorded. The primary outcome was the incidence of hypoxemia.
The lowest SpO during gastroscopy with propofol mono-sedation was significantly increased in the WNJT group compared with the nasal cannula group. The incidence of mild hypoxemia and total incidence of hypoxemia were significantly lower in the WNJT group than in the nasal cannula group. Other than a higher incidence of epistaxis in the WNJT group, the occurrence of adverse events was similar between the devices. While neither device demonstrated a statistically significant difference in satisfaction among patients, the WNJT did result in improved satisfaction among anesthetists and physicians.
During gastroscopy with propofol mono-sedation in obese patients, the WNJT, when compared with a nasal cannula for supplemental oxygen, can significantly reduce the occurrence of hypoxemia and improve both arterial oxygenation and satisfaction among anesthetists and physicians. The use of the WNJT may, however, lead to epistaxis in a few patients. In view of this clinically acceptable risk-benefit ratio, the WNJT may be recommended as an alternative tool for supplemental oxygen for the prevention of hypoxemia during gastroscopy with propofol mono-sedation in obese patients.
低氧血症是肥胖患者在丙泊酚单药镇静下行胃镜检查时常见的并发症。伟氏鼻喷射管（WNJT）是一种新型特殊鼻咽气道，能够通过其内置壁通道提供声门上喷射通气和氧气吹入。本研究旨在比较WNJT与鼻导管在肥胖患者丙泊酚单药镇静下胃镜检查时用于补充氧气的有效性和安全性。
比较WNJT与鼻导管在肥胖患者丙泊酚单药镇静下胃镜检查时用于补充氧气的有效性和安全性。
总共103例体重指数为30kg/m或更高且在丙泊酚单药镇静下接受择期胃镜检查的肥胖患者被随机分配，通过WNJT（WNJT组，n = 51）或鼻导管（鼻导管组，n = 52）以5L/min的速度接受补充氧气。记录胃镜检查期间的最低脉搏血氧饱和度（SpO）以及轻度和重度低氧血症情况。主要结局是低氧血症的发生率。
与鼻导管组相比，WNJT组在丙泊酚单药镇静下胃镜检查期间的最低SpO显著升高。WNJT组的轻度低氧血症发生率和低氧血症总发生率显著低于鼻导管组。除了WNJT组鼻出血发生率较高外，两种器械的不良事件发生率相似。虽然两种器械在患者满意度方面均未显示出统计学上的显著差异，但WNJT确实提高了麻醉医生和医生的满意度。
在肥胖患者丙泊酚单药镇静下进行胃镜检查时，与用于补充氧气的鼻导管相比，WNJT可显著降低低氧血症的发生率，并改善动脉氧合以及麻醉医生和医生的满意度。然而，使用WNJT可能会导致少数患者鼻出血。鉴于这种临床上可接受的风险效益比，WNJT可被推荐作为肥胖患者丙泊酚单药镇静下胃镜检查时预防低氧血症的补充氧气替代工具。
