Effect of nasal mask oxygenation on incidence of hypoxemia during gastroscopy with propofol sedation in patients at risk of hypoxemia: a prospective randomized controlled study

Abstract Background Hypoxemia is a prevalent complication during sedated gastroscopy and may result in significant adverse outcomes. We aimed to determine if nasal mask oxygenation could decrease the incidence of hypoxemia compared with standard oxygenation in patients with obesity or obstructive sl...

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Main Authors: Wenlong Yan, Liang Yan, Wenjun Meng, Jianyue Cai, Meiping Qian, Yan Zhang, Juan Li, Shuhua Shu, Fang Kang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-03245-1
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author Wenlong Yan
Liang Yan
Wenjun Meng
Jianyue Cai
Meiping Qian
Yan Zhang
Juan Li
Shuhua Shu
Fang Kang
author_facet Wenlong Yan
Liang Yan
Wenjun Meng
Jianyue Cai
Meiping Qian
Yan Zhang
Juan Li
Shuhua Shu
Fang Kang
author_sort Wenlong Yan
collection DOAJ
description Abstract Background Hypoxemia is a prevalent complication during sedated gastroscopy and may result in significant adverse outcomes. We aimed to determine if nasal mask oxygenation could decrease the incidence of hypoxemia compared with standard oxygenation in patients with obesity or obstructive sleep apnea (OSA) undergoing gastroscopy under deep sedation. Methods In a prospective randomized study, 120 patients aged 18 to 70 years, diagnosed with obesity or OSA, who underwent sedated gastroscopy, were randomized into two groups: Group M (nasal mask oxygenation) or Group C (nasal cannula oxygenation) from June 2024 to January 2025. The primary outcome was the incidence of hypoxemia (75%≤SpO2 < 90% for < 60 s) during the procedure. Secondary outcomes included the incidences of subclinical respiratory depression (90%≤SpO2 < 95% ) and severe hypoxemia (SpO2 < 75% or 75%≤SpO2 < 90% for > 60 s) during the procedure. Results Nasal mask oxygenation decreased the incidence of hypoxemia from 32.8 to 8.5% ( P < 0.001), subclinical respiratory depression from 48.3 to 20.3% ( P < 0.001), and severe hypoxemia from 13.8 to 1.7% ( P < 0.001). No significant differences in other sedation-related adverse events were observed between the two groups. Conclusion In patients with obesity or OSA, nasal mask oxygenation during gastroscopy with propofol sedation significantly reduced the incidences of hypoxemia, subclinical respiratory depression, and severe hypoxemia without increasing other adverse events. Trial registration Chinese Clinical Trial Registry (ChiCTR2400085162).
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spelling doaj-art-5d91f6217fe44823bb510f3c6edb0eb72025-08-20T03:46:24ZengBMCBMC Anesthesiology1471-22532025-07-012511810.1186/s12871-025-03245-1Effect of nasal mask oxygenation on incidence of hypoxemia during gastroscopy with propofol sedation in patients at risk of hypoxemia: a prospective randomized controlled studyWenlong Yan0Liang Yan1Wenjun Meng2Jianyue Cai3Meiping Qian4Yan Zhang5Juan Li6Shuhua Shu7Fang Kang8Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaGraduate School, Bengbu Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaDepartment of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaDepartment of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaDepartment of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaDepartment of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaDepartment of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaDepartment of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaAbstract Background Hypoxemia is a prevalent complication during sedated gastroscopy and may result in significant adverse outcomes. We aimed to determine if nasal mask oxygenation could decrease the incidence of hypoxemia compared with standard oxygenation in patients with obesity or obstructive sleep apnea (OSA) undergoing gastroscopy under deep sedation. Methods In a prospective randomized study, 120 patients aged 18 to 70 years, diagnosed with obesity or OSA, who underwent sedated gastroscopy, were randomized into two groups: Group M (nasal mask oxygenation) or Group C (nasal cannula oxygenation) from June 2024 to January 2025. The primary outcome was the incidence of hypoxemia (75%≤SpO2 < 90% for < 60 s) during the procedure. Secondary outcomes included the incidences of subclinical respiratory depression (90%≤SpO2 < 95% ) and severe hypoxemia (SpO2 < 75% or 75%≤SpO2 < 90% for > 60 s) during the procedure. Results Nasal mask oxygenation decreased the incidence of hypoxemia from 32.8 to 8.5% ( P < 0.001), subclinical respiratory depression from 48.3 to 20.3% ( P < 0.001), and severe hypoxemia from 13.8 to 1.7% ( P < 0.001). No significant differences in other sedation-related adverse events were observed between the two groups. Conclusion In patients with obesity or OSA, nasal mask oxygenation during gastroscopy with propofol sedation significantly reduced the incidences of hypoxemia, subclinical respiratory depression, and severe hypoxemia without increasing other adverse events. Trial registration Chinese Clinical Trial Registry (ChiCTR2400085162).https://doi.org/10.1186/s12871-025-03245-1GastroscopyHypoxemiaDeep sedationPatients with obesity
spellingShingle Wenlong Yan
Liang Yan
Wenjun Meng
Jianyue Cai
Meiping Qian
Yan Zhang
Juan Li
Shuhua Shu
Fang Kang
Effect of nasal mask oxygenation on incidence of hypoxemia during gastroscopy with propofol sedation in patients at risk of hypoxemia: a prospective randomized controlled study
BMC Anesthesiology
Gastroscopy
Hypoxemia
Deep sedation
Patients with obesity
title Effect of nasal mask oxygenation on incidence of hypoxemia during gastroscopy with propofol sedation in patients at risk of hypoxemia: a prospective randomized controlled study
title_full Effect of nasal mask oxygenation on incidence of hypoxemia during gastroscopy with propofol sedation in patients at risk of hypoxemia: a prospective randomized controlled study
title_fullStr Effect of nasal mask oxygenation on incidence of hypoxemia during gastroscopy with propofol sedation in patients at risk of hypoxemia: a prospective randomized controlled study
title_full_unstemmed Effect of nasal mask oxygenation on incidence of hypoxemia during gastroscopy with propofol sedation in patients at risk of hypoxemia: a prospective randomized controlled study
title_short Effect of nasal mask oxygenation on incidence of hypoxemia during gastroscopy with propofol sedation in patients at risk of hypoxemia: a prospective randomized controlled study
title_sort effect of nasal mask oxygenation on incidence of hypoxemia during gastroscopy with propofol sedation in patients at risk of hypoxemia a prospective randomized controlled study
topic Gastroscopy
Hypoxemia
Deep sedation
Patients with obesity
url https://doi.org/10.1186/s12871-025-03245-1
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