Clinical observation on the improvement of ventilation in obese patients under general anesthesia without intubation using high flow nasal oxygen tube combined with nasopharyngeal airway
Objective To observe the effect of high flow nasal cannula combined with nasopharyngeal airway on improving ventilation in obese patients under general anesthesia without intubation.Methods A total of 86 obese patients under general anesthesia without intubation admitted to the Lianyungang Hospital of Traditional Chinese Medicine from January to October 2023 were prospectively selected and randomly divided into a control group and an observation group using a random number table method,with 43 cases in each group.The observation group was given high flow nasal cannula combined with nasopharyngeal airway ventilation,while the control group was given ordinary nasal cannula combined with head lifting ventilation.Two groups were compared in terms of perioperative respiratory function,blood gas indicators,hemodynamics,pulse oximetry(SpO2),and complications.Results There was a statistically significant difference(F=7.548,P=0.001;F=7.658,P=0.002)in the final respiratory carbon dioxide pressure(PetCO2)and oxygenation index(OI)between the two groups with different oxygen flow rates of 2 L/min,4 L/min,and 6 L/min.The PetCO2 and OI in the observation group were higher than those in the control group at 4 L/min and 6 L/min,and the difference was statistically significant(all P＜0.05).There was a statistically significant difference(F=10.024,P＜0.001;F=10.236,P＜0.001)in the oxygen partial pressure(PaO2)and carbon dioxide partial pressure(PaCO2)before anesthesia(T0),10 minutes after anesthesia(T1),and at the end of surgery(T2)between the two groups.The PaO2 in the observation group was higher than that in the control group at T,and T2,while the PaCO2 was lower than that in the control group,and the difference was statistically significant(all P＜0.001).The difference in mean arterial pressure and heart rate at T0,T,,and T2 time points between the two groups was statistically significant(F=8.476,P＜0.001;F=8.321,P＜0.001).The average arterial pressure and heart rate at time points T,and T2 in the observation group were lower than those in the control group,and the difference was statistically significant(all P＜0.001).The comparison of SpO2 at T0,T,,and T2 time points between the two groups showed a statistically significant difference(F=7.548,P＜0.001).The SpO2 at T1 and T2 time points in the observation group was higher than that in the control group,and the difference was statistically significant(all P＜0.001).The total incidence of complications in the observation group was lower than that in the control group(P＜0.05).Conclusions High flow nasal cannula combined with nasopharyngeal airway can significantly improve perioperative respiratory function,blood gas indicators,and SpO2 in obese patients undergoing general anesthesia without intubation,stabilize hemodynamics,and reduce the risk of complications.
High flow nasal oxygen tubeNasopharyngeal airwayObesityGeneral anesthesia without intubationVentilate
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