Scholarlink

Background <p>High-flow nasal oxygen (HFNO) is increasingly used for preoxygenation and apneic oxygenation; however, its efficacy during anesthesia induction for frame-based stereoelectroencephalography (SEEG) remains uncertain. This study evaluated whether HFNO is non-inferior to facemask ventilation in maintaining oxygenation during anesthesia induction for frame-based SEEG.</p> Methods <p>In this randomized, controlled, non-inferiority trial, adult patients with refractory epilepsy undergoing frame-based SEEG were randomized to either the HFNO or facemask group. The primary endpoint was the lowest peripheral oxygen saturation (SpO<sub>2</sub>). Secondary endpoints included arterial blood gas analyses, hemodynamic measures, airway adjuncts use, first-pass intubation success (FPS), time to secure the airway, anesthesiologist satisfaction, patient comfort, and perioperative complications.</p> Results <p>Among 46 patients, the median (interquartile range [IQR]) lowest SpO<sub>2</sub> was 98 (97–99) % in the HFNO group vs. 96 (95–98) % in the facemask group, with a median difference of 1% (95 confidence interval [CI], 0–2%), confirming non-inferiority within a 2% margin. Post-intubation partial pressure of oxygen (PaO<sub>2</sub>) was significantly higher in the HFNO group than that in the facemask group, with median (IQR) of 437.8 (411.1–474.4) mmHg and 400.6 (365.6–435.2) mmHg, respectively. HFNO reduced the airway adjuncts use (0/23 vs. 6/23 patients; <i>p</i> = 0.022), shortened the time to secure the airway (<i>p</i> = 0.015), and improved anesthesiologist satisfaction and patient comfort (both <i>p</i> &lt; 0.0001). Hemodynamic parameters and FPS were similar between groups.</p> Conclusion <p>HFNO is non-inferior to facemask ventilation in maintaining oxygenation during anesthesia induction for frame-based SEEG. Moreover, HFNO reduces the need for airway adjuncts, shortens airway securement time, and enhances both patient and anesthesiologist satisfaction.</p> Trial registration <p>This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100044239; first registration date: March 12, 2021; <a href="https://www.chictr.org.cn/showproj.html?proj=119780">https://www.chictr.org.cn/showproj.html?proj=119780</a>).</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Application of high-flow nasal oxygen during anesthesia induction for frame-based stereoelectroencephalography: a randomized controlled non-inferiority trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年11月5日

查看全文
  • Xiaofen Sun,
  • Mingming Han,
  • Zefeng Fan,
  • Xiang Huang,
  • Fang Kang,
  • Juan Li

摘要

Background

High-flow nasal oxygen (HFNO) is increasingly used for preoxygenation and apneic oxygenation; however, its efficacy during anesthesia induction for frame-based stereoelectroencephalography (SEEG) remains uncertain. This study evaluated whether HFNO is non-inferior to facemask ventilation in maintaining oxygenation during anesthesia induction for frame-based SEEG.

Methods

In this randomized, controlled, non-inferiority trial, adult patients with refractory epilepsy undergoing frame-based SEEG were randomized to either the HFNO or facemask group. The primary endpoint was the lowest peripheral oxygen saturation (SpO2). Secondary endpoints included arterial blood gas analyses, hemodynamic measures, airway adjuncts use, first-pass intubation success (FPS), time to secure the airway, anesthesiologist satisfaction, patient comfort, and perioperative complications.

Results

Among 46 patients, the median (interquartile range [IQR]) lowest SpO2 was 98 (97–99) % in the HFNO group vs. 96 (95–98) % in the facemask group, with a median difference of 1% (95 confidence interval [CI], 0–2%), confirming non-inferiority within a 2% margin. Post-intubation partial pressure of oxygen (PaO2) was significantly higher in the HFNO group than that in the facemask group, with median (IQR) of 437.8 (411.1–474.4) mmHg and 400.6 (365.6–435.2) mmHg, respectively. HFNO reduced the airway adjuncts use (0/23 vs. 6/23 patients; p = 0.022), shortened the time to secure the airway (p = 0.015), and improved anesthesiologist satisfaction and patient comfort (both p < 0.0001). Hemodynamic parameters and FPS were similar between groups.

Conclusion

HFNO is non-inferior to facemask ventilation in maintaining oxygenation during anesthesia induction for frame-based SEEG. Moreover, HFNO reduces the need for airway adjuncts, shortens airway securement time, and enhances both patient and anesthesiologist satisfaction.

Trial registration

This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100044239; first registration date: March 12, 2021; https://www.chictr.org.cn/showproj.html?proj=119780).