Efficacy of high-flow nasal oxygenation compared with laryngeal mask airway in children undergoing ambulatory oral surgery under deep sedation: A randomized controlled non-inferiority trial

作者全名："Ran, Longkuan; Huang, Guijin; Yao, Ying; Wu, Yujia; Zhang, Chao; Wang, Yan; Yu, Cong"

作者地址："[Ran, Longkuan; Huang, Guijin; Yao, Ying; Wu, Yujia; Zhang, Chao; Wang, Yan; Yu, Cong] Affiliated Chongqing Med Univ, Dept Anesthesiol, Stomatol Hosp, Chongqing, Peoples R China; [Ran, Longkuan; Huang, Guijin; Yao, Ying; Wu, Yujia; Zhang, Chao; Wang, Yan; Yu, Cong] Chongqing Key Lab Oral Dis & Biomed Sci, Chongqing, Peoples R China; [Ran, Longkuan; Huang, Guijin; Yao, Ying; Wu, Yujia; Zhang, Chao; Wang, Yan; Yu, Cong] Chongqing Municipal Key Lab Oral Biomed Engn Highe, Chongqing, Peoples R China"

通信作者："Yu, C (通讯作者)，Affiliated Chongqing Med Univ, Dept Anesthesiol, Stomatol Hosp, Chongqing, Peoples R China.; Yu, C (通讯作者)，Chongqing Key Lab Oral Dis & Biomed Sci, Chongqing, Peoples R China.; Yu, C (通讯作者)，Chongqing Municipal Key Lab Oral Biomed Engn Highe, Chongqing, Peoples R China."

来源：FRONTIERS IN MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000899002000001

JCR分区：Q2

影响因子：3.9

年份：2022

卷号：9

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：high-flow nasal oxygenation; pediatric anesthesia; child ambulatory oral surgery; deep sedation; non-invasive ventilation

摘要："BackgroundHigh-flow nasal oxygenation (HFNO) has been suggested as an alternative oxygenation method during procedural sedation. This randomized, non-inferiority trial evaluated the safety and efficacy of HFNO compared with laryngeal mask airway (LMA) in pediatric ambulatory oral surgery under deep sedation. MethodsIn total, 120 children aged 2-7 years (weight: 10-30 kg) were equally assigned into two groups, namely, HFNO with propofol total intravenous anesthesia infusion (HFNO-IV) or LMA with propofol total intravenous anesthesia infusion (LMA-IV). The primary objective was to monitor carbon dioxide (CO2) accumulation during perioperative surgery. Secondary objectives included monitoring transcutaneous oxygen saturation, grade exposure to the surgical field, perioperative adverse events, or other events. The predefined non-inferiority margin was 7 mmHg. During the COVID-19 pandemic, a novel WeChat applet was implemented to gather follow-up data after discharge. ResultsNon-inferiority could be declared for HFNO relative to LMA (mean difference in transcutaneous CO2 (TcCO2) = -1.4 mmHg, 95% CI: -2.9, 0.1 mmHg; P > 0.05). The pre-surgical TcCO2 of the HFNO-IV group (45.4 +/- 4.5 mmHg) was similar to that of the LMA-IV group (44.0 +/- 3.5 mmHg), within the clinically acceptable normal range. All the children maintained SpO(2) levels of >97%. The surgical field exposure score of the HFNO group was significantly better than that of the LMA group. There was no significant difference between the two groups regarding risk or adverse events. ConclusionHFNO was not inferior to LMA for maintaining oxygenation and ventilation in patients undergoing pediatric ambulatory oral surgery under deep sedation under strict isolation from the oral cavity to the upper airway."

基金机构："Intelligent Medicine Project of Chongqing Medical University, China; CSA Clinical Research Fund [ZHYX202116]; [CSA-A2021-05]"

基金资助正文："This trial was supported by the Intelligent Medicine Project of Chongqing Medical University, China (Grant No. ZHYX202116) and the CSA Clinical Research Fund (CSA-A2021-05)."