Efficacy of high-flow nasal oxygenation during induction of general anaesthesia in parturients living with obesity: a two-centre, prospective, randomised clinical trial.

Authors

• Shuang-Qiong Zhou
• Jian-Feng Lian
• Yao Zhou
• Xiu-Hong Cao
• Xiu Ni
• Xiao-Peng Zhang
• Zhen-Dong Xu
• Quan-Sheng Xiao
• Zhi-Qiang Liu

Publication/Presentation Date

4-1-2025

Abstract

INTRODUCTION: High-flow nasal oxygenation has been shown to improve oxygenation during induction of anaesthesia in parturients who are not obese. However, data on the efficacy of high-flow nasal oxygen in parturients living with obesity are lacking. This study investigated the effects of high-flow nasal oxygenation on pre-oxygenation and apnoea oxygenation during tracheal intubation in parturients living with obesity.

METHODS: This prospective, randomised clinical trial was conducted at two tertiary hospitals and included parturients with BMI > 30 kg.m

RESULTS: 54 patients completed the study. The arterial partial pressure of oxygen after 3 min of pre-oxygenation was significantly lower in parturients allocated to the standard facemask group compared with those allocated to the high-flow nasal oxygen group (mean (SD) 40.1 (8.9) kPa vs. 53.8 (9.7) kPa, p <  0.001). End-tidal oxygen concentration on commencing ventilation was also lower in parturients allocated to the standard facemask group compared with those allocated to the high flow-nasal oxygen group (mean (SD) 78.3 (5.38)% vs. 86.2 (5.10)%, p <  0.001). The arterial partial pressure of carbon dioxide post tracheal intubation and fetal outcomes were similar in both groups.

DISCUSSION: Pre-oxygenation using high-flow nasal oxygenation provided a higher arterial partial pressure of oxygen and end-tidal oxygen concentration during general anaesthesia induction than standard facemask oxygenation in parturients living with obesity; however, the differences were not clinically meaningful. High-flow nasal oxygenation may be considered as an alternative option for pre-oxygenation during rapid sequence induction in parturients living with obesity.

Volume

80

Issue

4

First Page

378

Last Page

385

ISSN

1365-2044

Published In/Presented At

Zhou, S. Q., Lian, J. F., Zhou, Y., Cao, X. H., Ni, X., Zhang, X. P., Xu, Z. D., Xiao, Q. S., & Liu, Z. Q. (2025). Efficacy of high-flow nasal oxygenation during induction of general anaesthesia in parturients living with obesity: a two-centre, prospective, randomised clinical trial. Anaesthesia, 80(4), 378–385. https://doi.org/10.1111/anae.16492

Disciplines

Anesthesiology | Medicine and Health Sciences

PubMedID

39592199

Department(s)

Department of Anesthesiology

Document Type

Article