A single-sided trans-nasal catheter for smooth and efficient oxygen delivery can improve the safety in patients undergoing pancreato-biliary endoscopy under intravenous sedation: A randomized trial.

Autor: Ishii K; Department of Gastroenterology National Hospital Organization Yokohama Medical Center Kanagawa Japan., Kubota K; Department of Gastroenterology and Hepatology Yokohama City University, Graduate School of Medicine Kanagawa Japan., Nakao T; Department of Gastroenterology Kanto Rosai Hospital Kanagawa Japan., Koyama Y; Department of Hepato Biliary Pancreatic Medicine NTT Medical Center Tokyo Tokyo Japan., Fujita Y; Department of Hepato Biliary Pancreatic Medicine NTT Medical Center Tokyo Tokyo Japan., Akaba K; St. Marianna University School of Medicine Otolaryngology Kanagawa Japan., Matsuhashi N; Department of Gastroenterology Kanto Rosai Hospital Kanagawa Japan., Nakajima A; Department of Gastroenterology and Hepatology Yokohama City University, Graduate School of Medicine Kanagawa Japan.
Jazyk: angličtina
Zdroj: DEN open [DEN Open] 2022 Jun 12; Vol. 3 (1), pp. e130. Date of Electronic Publication: 2022 Jun 12 (Print Publication: 2023).
DOI: 10.1002/deo2.130
Abstrakt: Background: Pancreato-biliary endoscopic procedures often need to be performed under deep intravenous sedation. The patients are at an increased risk of respiratory depression influenced by the anatomical dead space of the upper respiratory system. We aimed to evaluate the benefit of oxygen delivery through a single-sided trans-nasal catheter (TC) for patients undergoing pancreato-biliary endoscopy.
Methods: Oxygen supplementation during the procedure was provided either by insertion of a single-sided TC or insertion of a conventional nasal catheter (NC). A prospective, single-blind, randomized controlled study was conducted in two groups.
Results: The number of patients who indicated a decrease in the peripheral transcutaneous oxygen saturation (SpO2; desaturation) was significantly lower in the TC group than in the counterpart (8/58; 13.8% vs. 26/58; 44.8% p < 0.001). The efficient oxygen delivery in the safe range was better conserved in the TC group than in the NC one. There was no adverse effect on both groups. The maximum SpO2 while the endoscopic procedure was significantly higher in the TC group (99.7% vs. 99.3% p = 0.016) and the minimum SpO2 was also significantly higher in the same group (97.7% vs. 94.1% p < 0.0001), which meant that the efficient oxygen delivery was better maintained in TC group than the NC group.
Conclusions: A single-sided TC placed in the pharynx in patients undergoing pancreato-biliary endoscopy prepares a superior condition of the patients for venous sedation, maintained hyper-oxygen saturation and a relatively higher SpO2 level to be maintained in limited conditions to reduce the dead space with acceptable tolerance, as compared to the placement of a conventional NC.
Competing Interests: The authors declare no conflict of interest.
(© 2022 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
Databáze: MEDLINE
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