High-flow nasal oxygen reduces the incidence of hypoxia in sedated hysteroscopy for assisted reproduction

Abstract

Backgrounds and aimsPain is the main reason for hysteroscopy failure. In day-surgical settings, hysteroscopy procedures are commonly performed with the patient under sedation. Hypoxia is the most common adverse event during sedation and can lead to severe adverse events. This study aimed to compare the incidence of hypoxia when using high-flow nasal oxygen (HFNO) with that when using regular nasal oxygen in patients undergoing hysteroscopy with sedation.Materials and methodsIn this single-center, prospective, randomized, single-blinded study, 960 female patients undergoing elective diagnostic or operative hysteroscopy were randomly enrolled into the following two groups: the regular nasal group [O2 (3–6 L/min) covered by an HFNO] and the HFNO group [O2 (30–60 L/min)] from September 2021 to December 2021. All women were sedated with propofol (1.5 mg/kg) and remifentanil (1.5 μg/kg) in the operating room. The primary outcome was the incidence of hypoxia (75% ≤ SpO2 < 90%, < 60 s).ResultsHFNO decreased the incidence of hypoxia (75% ≤ SpO2 < 90%, < 60 s), subclinical respiratory depression (90% ≤ SpO2 < 95%) and severe hypoxia (SpO2 < 75% for any duration or 75% ≤ SpO2 < 90% for ≥ 60 s) from 24.38 to 0.83%, from 11.25 to 1.46% and from 3.75 to 0%, respectively (P < 0.001).ConclusionIn procedures conducted to treat female infertility, HFNO can reduce hypoxia during hysteroscopy in patients sedated with propofol, and it can prevent the occurrence of subclinical respiratory depression and severe hypoxia.

The Current Situation of Anaesthesia for Hysteroscopy in Mainland China: A National Survey

“…It can provide heated and humidified, titrated and regulated oxygen concentration via a nasal catheter. Our previous research revealed an advantage of HFNO in reducing the incidence of hypoxia during sedation for hysteroscopy [39]. However, only 1.1% of institutions used HFNO in the practice of sedation of hysteroscopic procedure in our investigation.…”

Place of high-flow nasal oxygen in nonoperating room anesthesia

“…These results were also observed across subgroups, including variations in the type of procedures, the FiO 2 , the hypoxemic profile of the patients, and the mode of propofol administration [35 && ]. Additional indications, such as computed tomography-guided hepatic tumor radiofrequency ablation [36], awake craniotomy [37], and hysteroscopy for assisted reproduction [38], also demonstrated favorable outcomes with the use of HFNO.…”

“…Additional indications, such as computed tomography-guided hepatic tumor radiofrequency ablation [36], awake craniotomy [37], and hysteroscopy for assisted reproduction [38], also demonstrated favorable outcomes with the use of HFNO.…”