title: A nasal high-flow system prevents hypoxia in dental patients under intravenous sedation.
abstract: OBJECTIVE
  Hypoxia is a major complication in dental patients under intravenous sedation (IVS). A nasal high-flow (NHF) system has been reported to achieve effective oxygenation in patients with sleep apnea syndrome. This study investigated the ability of the NHF system to prevent hypoxia in dental patients under IVS.
  
  
  METHODS
  Thirty patients scheduled for dental treatment under IVS were enrolled. Patients were randomly divided into 3 groups: patients spontaneously breathing oxygen at 5 L/minute through a nasal cannula (NC5 group), patients administered oxygen at 30 L/minute through the NHF system, and patients administered oxygen at 50 L/minute through the NHF system. Hypnosis was induced by bolus administration of midazolam (0.05 mg/kg) followed by continuous administration of propofol (target blood concentration, 1.2 to 2 μg/mL). Noninvasive blood pressure, peripheral capillary oxygen saturation (SpO2), heart rate, and bispectral index values were recorded every 2.5 minutes before the induction of anesthesia. Interventions, such as jaw lifting, were recorded during IVS and arterial blood gas analysis was performed at the end of sedation. Patient and surgeon satisfaction with IVS was evaluated by interview.
  
  
  RESULTS
  Minimum SpO2 was lowest in and surgeons were least satisfied with the NC5 group. In addition, interventions were required most frequently in the NC5 group (P < .05). Compared with the NC5 group, use of the NHF system improved partial pressures of oxygen and carbon dioxide in dental patients under IVS (P < .05).
  
  
  CONCLUSIONS
  These results suggest that use of the NHF system can prevent hypoxia in dental patients under IVS. Further studies are necessary to determine the appropriate flow rate and indications for NHF in obese patients.
authors: Assistant Professor, Department of Dental Anesthesiology, Kyushu Dental University, Fukuoka, Japan. Electronic address: r07sagou@fa.kyu-dent.ac.jp.
authors: Teppei
authors: T
authors: Sago
authors: Assistant Professor, Department of Dental Anesthesiology, Kyushu Dental University, Fukuoka, Japan.
authors: Nozomu
authors: N
authors: Harano
authors: Clinical Research Fellow, Department of Dental Anesthesiology, Kyushu Dental University, Fukuoka, Japan.
authors: Yuki
authors: Y
authors: Chogyoji
authors: Assistant Professor, Department of Dental Anesthesiology, Kyushu Dental University, Fukuoka, Japan.
authors: Masahito
authors: M
authors: Nunomaki
authors: Associate Professor, Department of Dental Anesthesiology, Kyushu Dental University, Fukuoka, Japan.
authors: Shunji
authors: S
authors: Shiiba
authors: Professor, Department of Dental Anesthesiology, Kyushu Dental University, Fukuoka, Japan.
authors: Seiji
authors: S
authors: Watanabe
mesh_terms: D000328:Adult; D058109:Airway Management / Q000379:methods; D000766:Anesthesia, Dental / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001785:Blood Gas Monitoring, Transcutaneous / Q000379:methods; D001794:Blood Pressure / Q000502:physiology; D016292:Procedural Sedation / Q000379:methods*; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000379:methods*; D004569:Electroencephalography / Q000379:methods; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D000860:Hypoxia / Q000517:prevention & control*; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019647:Oral Surgical Procedures / Q000379:methods*; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation / Q000379:methods*; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008874:Midazolam; D010100:Oxygen; D015742:Propofol