Improved Tubeless Airway Management in JORRP Surgery: Comparative Analysis of Pre- and Post-THRIVE Implementation

Guiyu Lei,1 Siliu Yang,2 Lili Wu,1 Yue Yin,1 Chunhua Xi,1 Yang Xiao,3 Guyan Wang1 1Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People’s Republic of China; 2Department of Anesthesiology, Beijing Dongcheng Maternal and Child Health Care Hospital...

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Main Authors: Lei G, Yang S, Wu L, Yin Y, Xi C, Xiao Y, Wang G
Format: Article
Language:English
Published: Dove Medical Press 2025-05-01
Series:Therapeutics and Clinical Risk Management
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Online Access:https://www.dovepress.com/improved-tubeless-airway-management-in-jorrp-surgery-comparative-analy-peer-reviewed-fulltext-article-TCRM
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author Lei G
Yang S
Wu L
Yin Y
Xi C
Xiao Y
Wang G
author_facet Lei G
Yang S
Wu L
Yin Y
Xi C
Xiao Y
Wang G
author_sort Lei G
collection DOAJ
description Guiyu Lei,1 Siliu Yang,2 Lili Wu,1 Yue Yin,1 Chunhua Xi,1 Yang Xiao,3 Guyan Wang1 1Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People’s Republic of China; 2Department of Anesthesiology, Beijing Dongcheng Maternal and Child Health Care Hospital, Beijing, 100007, People’s Republic of China; 3Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology, Head and Neck Surgery (Ministry of Education of China), Beijing, 100730, People’s Republic of ChinaCorrespondence: Guyan Wang, Department of Anaesthesiology, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang, Dongcheng District, Beijing, 100730, People’s Republic of China, Tel +86 13910985139, Email guyanwang2006@163.comBackground: Juvenile-onset recurrent respiratory papillomatosis (JORRP) is a severe pediatric condition requiring frequent surgical interventions to maintain airway patency. Managing oxygenation during tubeless anesthesia for these surgeries poses significant challenges. In 2021, our center introduced transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) as a novel method for airway management in JORRP surgeries. This study evaluated the impact of THRIVE on perioperative outcomes in pediatric JORRP surgeries.Methods: This was a retrospective study of 122 pediatric JORRP surgical cases carried out at a tertiary center. Patients who underwent surgery prior to the implementation of THRIVE served as the control group (pre-THRIVE), while those treated after its introduction served as the intervention group (post-THRIVE), with 61 patients in each group. Perioperative data, including surgery and anesthesia parameters and extubation frequency were collected.Results: A total of 122 patients were included. Baseline characteristics were comparable between groups. After the introduction of THRIVE, the median number of extubations significantly decreased from a median 3 in the pre-THRIVE group to 1 in the post-THRIVE group (P < 0.001). Minimum intraoperative SpO2 levels were significantly higher in the post-THRIVE group (98% vs 85%, P < 0.001). Surgery duration was reduced from 41 minutes to 35.5 minutes (P =0.003), and anesthesia duration decreased from 67 minutes to 58.5 minutes (P =0.016). No significant differences were observed in PACU stay length or complications between the groups.Conclusion: The implementation of THRIVE in pediatric JORRP enhances intraoperative efficiency and safety. Further research is warranted to assess its long-term effect.Keywords: THRIVE, JORRP, tubeless anesthesia, airway management, SpO2
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spelling doaj-art-2a84f5c35a2a4dc1bcfb818dd29087232025-08-20T03:09:32ZengDove Medical PressTherapeutics and Clinical Risk Management1178-203X2025-05-01Volume 21Issue 1647654102777Improved Tubeless Airway Management in JORRP Surgery: Comparative Analysis of Pre- and Post-THRIVE ImplementationLei G0Yang S1Wu L2Yin Y3Xi C4Xiao Y5Wang G6Department of AnesthesiologyAnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyGuiyu Lei,1 Siliu Yang,2 Lili Wu,1 Yue Yin,1 Chunhua Xi,1 Yang Xiao,3 Guyan Wang1 1Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People’s Republic of China; 2Department of Anesthesiology, Beijing Dongcheng Maternal and Child Health Care Hospital, Beijing, 100007, People’s Republic of China; 3Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology, Head and Neck Surgery (Ministry of Education of China), Beijing, 100730, People’s Republic of ChinaCorrespondence: Guyan Wang, Department of Anaesthesiology, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang, Dongcheng District, Beijing, 100730, People’s Republic of China, Tel +86 13910985139, Email guyanwang2006@163.comBackground: Juvenile-onset recurrent respiratory papillomatosis (JORRP) is a severe pediatric condition requiring frequent surgical interventions to maintain airway patency. Managing oxygenation during tubeless anesthesia for these surgeries poses significant challenges. In 2021, our center introduced transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) as a novel method for airway management in JORRP surgeries. This study evaluated the impact of THRIVE on perioperative outcomes in pediatric JORRP surgeries.Methods: This was a retrospective study of 122 pediatric JORRP surgical cases carried out at a tertiary center. Patients who underwent surgery prior to the implementation of THRIVE served as the control group (pre-THRIVE), while those treated after its introduction served as the intervention group (post-THRIVE), with 61 patients in each group. Perioperative data, including surgery and anesthesia parameters and extubation frequency were collected.Results: A total of 122 patients were included. Baseline characteristics were comparable between groups. After the introduction of THRIVE, the median number of extubations significantly decreased from a median 3 in the pre-THRIVE group to 1 in the post-THRIVE group (P < 0.001). Minimum intraoperative SpO2 levels were significantly higher in the post-THRIVE group (98% vs 85%, P < 0.001). Surgery duration was reduced from 41 minutes to 35.5 minutes (P =0.003), and anesthesia duration decreased from 67 minutes to 58.5 minutes (P =0.016). No significant differences were observed in PACU stay length or complications between the groups.Conclusion: The implementation of THRIVE in pediatric JORRP enhances intraoperative efficiency and safety. Further research is warranted to assess its long-term effect.Keywords: THRIVE, JORRP, tubeless anesthesia, airway management, SpO2https://www.dovepress.com/improved-tubeless-airway-management-in-jorrp-surgery-comparative-analy-peer-reviewed-fulltext-article-TCRMTHRIVEJORRPtubeless anesthesiaairway managementSpO2
spellingShingle Lei G
Yang S
Wu L
Yin Y
Xi C
Xiao Y
Wang G
Improved Tubeless Airway Management in JORRP Surgery: Comparative Analysis of Pre- and Post-THRIVE Implementation
Therapeutics and Clinical Risk Management
THRIVE
JORRP
tubeless anesthesia
airway management
SpO2
title Improved Tubeless Airway Management in JORRP Surgery: Comparative Analysis of Pre- and Post-THRIVE Implementation
title_full Improved Tubeless Airway Management in JORRP Surgery: Comparative Analysis of Pre- and Post-THRIVE Implementation
title_fullStr Improved Tubeless Airway Management in JORRP Surgery: Comparative Analysis of Pre- and Post-THRIVE Implementation
title_full_unstemmed Improved Tubeless Airway Management in JORRP Surgery: Comparative Analysis of Pre- and Post-THRIVE Implementation
title_short Improved Tubeless Airway Management in JORRP Surgery: Comparative Analysis of Pre- and Post-THRIVE Implementation
title_sort improved tubeless airway management in jorrp surgery comparative analysis of pre and post thrive implementation
topic THRIVE
JORRP
tubeless anesthesia
airway management
SpO2
url https://www.dovepress.com/improved-tubeless-airway-management-in-jorrp-surgery-comparative-analy-peer-reviewed-fulltext-article-TCRM
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