Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5479
Peer-review started: March 16, 2021
First decision: May 1, 2021
Revised: May 7, 2021
Accepted: May 19, 2021
Article in press: May 19, 2021
Published online: July 16, 2021
Processing time: 113 Days and 3.3 Hours
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 via its built-in wall channels. The aim of this study was to compare the efficacy and safety of the WNJT vs a nasal cannula for supplemental oxygen during gastro
To compare the efficacy and safety of the WNJT vs 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/m2 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, n = 51) or a nasal cannula (nasal cannula group, n = 52). The lowest pulse oxygen saturation (SpO2) and mild and severe hypoxemia during gastro
The lowest SpO2 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.
Core Tip: This study is a prospective, randomized controlled trial aimed to compare the efficacy and safety of Wei nasal jet tube (WNJT) and nasal prongs for supplemental oxygen during gastroscopy with propofol monosedation in obese patients when a moderate oxygen flow is used. Our results show that the WNJT compared with the nasal prongs for supplemental oxygen is more effective for prevention of hypoxemia during gastroscopy with propofol mono-sedation, though it may result in a potential risk of epistaxis in few patients.