Effect of nasal or nasopharyngeal apneic oxygenation on desaturation during induction of anesthesia and endotracheal intubation in the operating room: A narrative review of randomized controlled trials

OBJECTIVES: To determine whether apneic oxygenation through nasal or nasopharyngeal catheters can counteract hypoxemia and desaturation during induction of anesthesia and endotracheal intubation.

DESIGN: Narrative review of randomized controlled trials.

SETTING: Operating room.

PATIENTS: 295 ASA I-II patients in elective surgery.

INTERVENTION: PubMed and Embase databases were searched for studies with apneic oxygenation. The review included randomized controlled trials with apneic oxygenation through nasal or nasopharyngeal catheters as the intervention in the setting of endotracheal intubation in adults.

MEASUREMENTS: Outcome measures were time until desaturation or degree of hypoxemia.

MAIN RESULTS: Eight randomized controlled trials were included, with a total of 295 patients. Apneic oxygenation was administered by nasopharyngeal catheter in four studies and by nasal catheter in four studies. The eight included articles studied apneic oxygenation at flow rates of 3-10 l/min in ASA I-II patients undergoing elective anesthesia in the operating room. Apneic oxygenation significantly prolonged time until desaturation opposed to the control groups in seven of the eight studies of patients undergoing anesthesia for elective surgery.

CONCLUSION: Apneic oxygenation through nasal or nasopharyngeal catheters can prolong time to desaturation and decrease degree of desaturation during induction of anesthesia and endotracheal intubation in adult ASA I-II patients undergoing anesthesia for elective surgery.