Zhi-Yu Yin,* Hao Gao,* Jing Wang, Pan Wei, Jun Guo, Wei Tang

Department of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200001, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Wei Tang; Jun Guo, Department of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 185 of Pu-an Road, Shanghai, Huangpu District, 200001, People’s Republic of China, Tel +86-021-53827217, Email weiwwtang@126.com; jun_guo82@126.com

Objective: This study aims to evaluate the safety and efficacy of using bilateral nasopharyngeal airways (NPA) during colonoscopic polypectomy performed under sedation anesthesia in obese patients.
Methods: Ninety obese patients undergoing colonoscopic polypectomy under elective sedation anesthesia at Shanghai Shuguang Hospital were randomly allocated to two groups. Patients in group B had a nasopharyngeal airway inserted bilaterally after induction of anesthesia, whereas patients in group U had a nasopharyngeal airway inserted in only one nostril. Spontaneous breathing was maintained in both groups. The primary observation parameter was the incidence of oxygen saturation (SpO2) ≤ 92% during anesthesia, while secondary observation parameters included preoperative, intraoperative, and post-operative SpO2 levels, mean arterial pressure (MAP), heart rate (HR), dosage of propofol, duration of the operation, time to anesthesia recovery, need for emergency airway intervention, and occurrence of other adverse events.
Results: Hypoxia occurred in 5 out of 45 patients (11.1%) in group B, whereas it was observed in 14 out of 45 patients (31.1%) in group U (P < 0.05). Patients in group B exhibited higher SpO2 levels during and after surgery compared to those in group U (P <  0.05). Furthermore, the decrease in intraoperative and post-operative SpO2 levels from baseline was significantly lower in group B compared to group U (P < 0.05). The number of emergency airway interventions, operation time, propofol dosage, and anesthesia recovery time were significantly lower in group B compared to group U (P <  0.05). However, there were no significant differences in MAP, HR, or the incidence of adverse events between the two groups (P >  0.05).
Conclusion: The utilization of bilateral nasopharyngeal airway placement proves to be an effective strategy in decreasing the occurrence of hypoxia among obese patients undergoing colonoscopy under sedation anesthesia, thereby improving procedural safety.

Keywords: bilateral, colonoscopy, colorectal polypectomy, nasopharyngeal airway, obese patients, sedation anesthesia