Intravenous anesthesia with high-flow nasal cannula improves recovery in elderly undergoing ureteroscopic lithotripsy: a prospective controlled study
Abstract Background Intravenous anesthesia with high-flow nasal cannula (HFNC) has been reported to benefit oxygen reserves and enhance postoperative recovery in surgeries requiring low neuromuscular blockade. This study investigated whether HFNC improves recovery quality in elderly undergoing urete...
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BMC
2025-01-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-024-02869-z |
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| author | Lifei Tang Ran Guo Yaochen Quan Haiwen Zhang Yingcong Qian Youjia Yu Shaoyong Song Jian Li |
| author_facet | Lifei Tang Ran Guo Yaochen Quan Haiwen Zhang Yingcong Qian Youjia Yu Shaoyong Song Jian Li |
| author_sort | Lifei Tang |
| collection | DOAJ |
| description | Abstract Background Intravenous anesthesia with high-flow nasal cannula (HFNC) has been reported to benefit oxygen reserves and enhance postoperative recovery in surgeries requiring low neuromuscular blockade. This study investigated whether HFNC improves recovery quality in elderly undergoing ureteroscopic holmium laser lithotripsy (UHLL). Methods We enrolled 106 elderly patients undergoing UHLL, with 96 patients (48 per group) included in the final analysis. Patients were randomly assigned (1:1, stratified by sex) to receive either HFNC (HFNC group) or laryngeal mask airway (LMA) assisted general anesthesia (LMA group). The primary outcome was the Quality of Recovery 15-questionnaire (QoR-15) scores. Secondary outcomes included PACU stay duration, time to out-of-bed mobilization, length of hospital stay, airway dryness scores, surgeons’ satisfaction, and postoperative complications. Results Compared to the LMA group, the HFNC group achieved significantly higher QoR-15 scores (125.5 [118.3–130.0] vs. 136.5 [126.3–139.0]; difference = -9, 95%CI, -11 to -5; P < 0.001) on the first postoperative day. For secondary outcomes, the HFNC group had a shorter PACU stay (difference = 11.6 min, 95% CI, 10.4–12.8 min), earlier out-of-bed mobilization (difference = 31.8 min, 95% CI, 30.6–33.1 min), lower mouth (difference = 2, 95% CI, 1–3) and throat dryness scores (difference = 2, 95% CI, 1–3) at 30 min post-operation, and lower rates of postoperative sore throat (14.6% vs. 0%; P = 0.019) and cough with sputum (odds ratio [OR] = 9.4, 95% CI, 1.1–78.4). No significant differences were observed between the groups for other measures. Conclusions HFNC can improve recovery quality in elderly patients after UHLL compared to LMA-assisted general anesthesia. Trial registration This trial was registered on July 20, 2023, in the Chinese Clinical Trial Registry (ChiCTR2300073757). |
| format | Article |
| id | doaj-art-e1db30bbdac047e2b95d9eb2863e4357 |
| institution | Kabale University |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj-art-e1db30bbdac047e2b95d9eb2863e43572025-01-05T12:44:05ZengBMCBMC Anesthesiology1471-22532025-01-0125111010.1186/s12871-024-02869-zIntravenous anesthesia with high-flow nasal cannula improves recovery in elderly undergoing ureteroscopic lithotripsy: a prospective controlled studyLifei Tang0Ran Guo1Yaochen Quan2Haiwen Zhang3Yingcong Qian4Youjia Yu5Shaoyong Song6Jian Li7Department of Anesthesiology, The 904 th Hospital of the Joint Service Support Force of the Chinese People’s Liberation ArmyDepartment of Pain Medicine, Zhejiang Provincial People’s HospitalDepartment of Anesthesiology, The 904 th Hospital of the Joint Service Support Force of the Chinese People’s Liberation ArmyDepartment of Anesthesiology, The Fourth Affiliated Hospital of Soochow UniversityDepartment of Anesthesiology, The Fourth Affiliated Hospital of Soochow UniversityDepartment of Anesthesiology, Suzhou Xiangcheng People’s HospitalDepartment of Anesthesiology, The Fourth Affiliated Hospital of Soochow UniversityDepartment of Anesthesiology, The Fourth Affiliated Hospital of Soochow UniversityAbstract Background Intravenous anesthesia with high-flow nasal cannula (HFNC) has been reported to benefit oxygen reserves and enhance postoperative recovery in surgeries requiring low neuromuscular blockade. This study investigated whether HFNC improves recovery quality in elderly undergoing ureteroscopic holmium laser lithotripsy (UHLL). Methods We enrolled 106 elderly patients undergoing UHLL, with 96 patients (48 per group) included in the final analysis. Patients were randomly assigned (1:1, stratified by sex) to receive either HFNC (HFNC group) or laryngeal mask airway (LMA) assisted general anesthesia (LMA group). The primary outcome was the Quality of Recovery 15-questionnaire (QoR-15) scores. Secondary outcomes included PACU stay duration, time to out-of-bed mobilization, length of hospital stay, airway dryness scores, surgeons’ satisfaction, and postoperative complications. Results Compared to the LMA group, the HFNC group achieved significantly higher QoR-15 scores (125.5 [118.3–130.0] vs. 136.5 [126.3–139.0]; difference = -9, 95%CI, -11 to -5; P < 0.001) on the first postoperative day. For secondary outcomes, the HFNC group had a shorter PACU stay (difference = 11.6 min, 95% CI, 10.4–12.8 min), earlier out-of-bed mobilization (difference = 31.8 min, 95% CI, 30.6–33.1 min), lower mouth (difference = 2, 95% CI, 1–3) and throat dryness scores (difference = 2, 95% CI, 1–3) at 30 min post-operation, and lower rates of postoperative sore throat (14.6% vs. 0%; P = 0.019) and cough with sputum (odds ratio [OR] = 9.4, 95% CI, 1.1–78.4). No significant differences were observed between the groups for other measures. Conclusions HFNC can improve recovery quality in elderly patients after UHLL compared to LMA-assisted general anesthesia. Trial registration This trial was registered on July 20, 2023, in the Chinese Clinical Trial Registry (ChiCTR2300073757).https://doi.org/10.1186/s12871-024-02869-zHigh flow nasal cannulaIntravenous anesthesiaUreteroscopic holmium laser lithotripsyElderlyRecovery quality |
| spellingShingle | Lifei Tang Ran Guo Yaochen Quan Haiwen Zhang Yingcong Qian Youjia Yu Shaoyong Song Jian Li Intravenous anesthesia with high-flow nasal cannula improves recovery in elderly undergoing ureteroscopic lithotripsy: a prospective controlled study BMC Anesthesiology High flow nasal cannula Intravenous anesthesia Ureteroscopic holmium laser lithotripsy Elderly Recovery quality |
| title | Intravenous anesthesia with high-flow nasal cannula improves recovery in elderly undergoing ureteroscopic lithotripsy: a prospective controlled study |
| title_full | Intravenous anesthesia with high-flow nasal cannula improves recovery in elderly undergoing ureteroscopic lithotripsy: a prospective controlled study |
| title_fullStr | Intravenous anesthesia with high-flow nasal cannula improves recovery in elderly undergoing ureteroscopic lithotripsy: a prospective controlled study |
| title_full_unstemmed | Intravenous anesthesia with high-flow nasal cannula improves recovery in elderly undergoing ureteroscopic lithotripsy: a prospective controlled study |
| title_short | Intravenous anesthesia with high-flow nasal cannula improves recovery in elderly undergoing ureteroscopic lithotripsy: a prospective controlled study |
| title_sort | intravenous anesthesia with high flow nasal cannula improves recovery in elderly undergoing ureteroscopic lithotripsy a prospective controlled study |
| topic | High flow nasal cannula Intravenous anesthesia Ureteroscopic holmium laser lithotripsy Elderly Recovery quality |
| url | https://doi.org/10.1186/s12871-024-02869-z |
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