ISSN: 1859 - 2872
Comparison of the effectiveness of apnoeic oxygenation with high‐flow nasal oxygen between 40 liters/minute and 70 liters/minute during endoscopic vocal cord surgery
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Abstract
Objective: The study aimed to compare the effectiveness of apnoeic ventilation with high‐flow oxygen between 40 liters/minute and 70 liters/minute for airway management during endoscopic vocal cord surgery. Subject and method: From October 2022 to December 2024 at the 108 Military Central Hospital, 122 patients aged 24-77 years old with indications for endoscopic vocal cord surgery were randomly divided into two groups: Group HF40 was provided with high-flow nasal oxygen (HFNC) at a flow of 40 liters/minute, group HF70 used a flow of 70 liters/minute. Patients received total anesthesia and neuromuscular blocking agents during surgery and airway management using high-flow oxygen under the apnoeic conditions as the sole method of gas exchange. Result: The difference in apnea time and surgery time between the two groups was not statistically significant, 18.70 (2.56) minutes and 18.20 (2.29) minutes, 17.15 (2.52) minutes and 16.61 (2.13) minutes, respectively. The oxygen saturation was stable during all procedures at 99-100%. PaO2 in both study groups remained above 200mmHg, ensuring sufficient O2 supply for the patient. PaO2 at all times of the 70 liters/minute group remained significantly higher with p<0.05 compared to the 40 liters/minute group. A blood gas analysis showed hypercapnia and acidosis acute respiratory. However, after 15 minutes of ventilation, the parameters returned to normal. The rate of patients with pain and dryness in the nasopharynx in the HF40 group was statistically less than in the HF70 group, with p<0.05. There were no complications such as bleeding, hemothorax, pneumothorax, or barotrauma. Conclusion: Apnoeic ventilation with high‐flow oxygen 40l/minute and 70l/minute for airway management during endoscopic vocal cord surgery is a safe and effective method for gas exchange. All patients in both groups had acute respiratory acidosis but wholly returned to normal after 15 minutes of anesthesia release. The rate of patients with sore throat and dry mouth in the HF40 group was lower than in the HF70 group.
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References
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