Supraglottic jet oxygenation and ventilation during colonoscopy under monitored anesthesia care: a controlled randomized clinical trial

摘要

OBJECTIVE: Supraglottic jet oxygenation and ventilation may provide active pulse oxygenation and ventilation in patients with respiratory suppression. This randomized controlled clinical study was designed to determine the efficacy and safety of supraglottic jet oxygenation/ventilation during monitored anesthesia care (MAC) by intravenous (IV) infusion of propofol in patients undergoing colonoscopy. PATIENTS AND METHODS: Forty-nine adult patients receiving colonoscopy were randomly divided into two groups: the control group with passive oxygen supply from regular nasal cannula (N = 24) and the supraglottic jet oxygenation/ventilation (SJV) group with active pulse oxygen supply and ventilation using a manual jet ventilator (N = 25). MAC was induced and maintained by intravenous injection of propofol. HR, ECG, BP, SaO2 were continuously monitored during and 1 hour after the procedure. RESULTS: Demographic characteristics were similar in height, weight, age and BMI (Body Mass Index) between the two groups. Compared to the control group, the SJV group had similar averaged lowest SaO2, but highest SaO2 in SJV group were significantly lower during operation (p = 0.01). The proportion of maximum chest rise movement were increased significantly in SJV group (p = 0.03) compared with control group. Demographic characteristics were similar in the times needed to use facial mask ventilation, percentage of time to maintain SaO2 above 96%, average PetCO2 during the procedure, or complications between the two groups. CONCLUSIONS: SJV can provide adequate oxygenation/ventilation during monitored anesthesia care and convenient monitoring for patients’ breath, without complications.