Application of a new special-shaped nasopharyngeal catheter in painless gastroscopy in patients with OSAHS
WU Tong1,2, TAO Tianzhu2, YANG Xiaoming2, DONG Jiaxin1,2, CHEN Yuqi1,2, LI Bairong3, YE Bo2
1. Graduate School of China Medical University, Shenyang 110122,China; 2. Department of Anesthesiology,3. Department of Gastroenterology, Characteristics Medical Center of PLA Air Force, Beijing 100142,China
Abstract：Objective To investigate the safety and efficacy of a new type of special-shaped nasopharyngeal catheter in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) undergoing painless gastroscopy. Methods A total of 90 OSAHS patients who underwent painless gastroscopy examination in the outpatient department of Characteristics Medical Center of PLA Air Force from October 2022 to March 2023 were randomly divided into a control group (Group C), nasopharyngeal airway group 1 (Group NPA1), and nasopharyngeal airway group 2 (Group NPA2). Oxygen masks were used in Group C for oxygen inhalation, while NPA1 and NPA2 were given by nasopharyngeal catheter, and PetCO2 was monitored in group NPA2. The general condition, airway assessment indicators (Malampati classification), incidence of hypoxemia in painless gastroenteroscopy, incidence of respiratory depression, auxiliary ventilation rate, minimum oxygen saturation, and the interval time from hypoxemia alarm value to hypoxemia occurrence were observed and compared among the groups. Results The incidence of respiratory depression in Group NPA1(40.0%) was lower than that in Group C (70.0%) .The incidence of hypoxemia in Group NPA1 (23.3%) was lower than that in Group C (50.0%), and auxiliary ventilation rate in Group NPA1(33.3%) was lower than that in Group NPA2 (46.7%) and lower than that in Group C (66.7%). The lowest blood oxygen saturation in Group NPA1 [(92 93±3.60)%] was higher than that of Group C[(90.20±4.34)%], and lower than that of Group NPA2 [(94.67±2.63)%]. The time interval between alarm value of hypoxemia and occurrence of hypoxemia in Group NPA2 [(63.25±10.28)s] was longer than that in Group NPA1 [(22.14±4.10)s], and the difference was statistically significant (P<0 05). In Group C, 2 subjects were transferred to Group NPA1 due to persistent hypoxemia, and SpO2 gradually recovered to normal level after the placement of nasopharyngeal catheter. Conclusions The new special-shaped nasopharynx catheter can effectively reduce the incidence of respiratory depression and hypoxemia, and improve the safety of painless gastroscopy for OSAHS patients. Combined PetCO2 monitoring can guide anesthesiologists to conduct auxiliary ventilation treatment, further reduce the incidence of respiratory depression, and improve the safety of surgery.
吴桐, 陶天柱, 杨晓明, 董佳欣, 陈宇祺, 李白容, 叶博. 新型异形鼻咽通气管在阻塞性睡眠呼吸暂停低通气综合征患者行无痛胃肠镜检查中的应用[J]. 武警医学, 2023, 34(12): 1021-1024.
WU Tong, TAO Tianzhu, YANG Xiaoming, DONG Jiaxin, CHEN Yuqi, LI Bairong, YE Bo. Application of a new special-shaped nasopharyngeal catheter in painless gastroscopy in patients with OSAHS. Med. J. Chin. Peop. Armed Poli. Forc., 2023, 34(12): 1021-1024.
Apfelbaum J L, Hagberg C A, Caplan R A, et al. Practice guidelines for management of the difficult airway: an updated report by the americansociety of anesthesiologists task force on management of the difficult airway [J]. Anesthesiology, 2013,118(2): 251-270.
Siobal M S. Monitoring exhaled carbon dioxide [J].Respir Care,2016, 61(10): 1397-1416.
[11]
Zhang C,Wang M, Wang R,et al.Accuracy of end-tidal CO2 measurement through the nose and pharynx in nonintubated patients during digital subtraction cerebral angiography[J].J Neurosurg Anesth,2013,25(2):191-196.
[12]
Cereceda-Sánchez F J, Molina-Mula J.Capnography as a tool to detect metabolic changes in patients cared for in the emergency setting [J]. Rev Lat Am Enfermagem,2017,25:e2885.
2023, Vol. 34 
