The Nasal High-flow System Keeps Obese Individuals Oxygenated During Sedation

Objectives: During sedation, airway management aimed at maintaining the patient’s oxygen levels is important for patient safety. In anesthetic management, it is widely accepted that obese patients are more likely to suffer airway blockages and reductions in arterial oxygen saturation (SpO₂) than non-obese patients. Therefore, airway obstruction and hypoxia are major incidents that anesthetists often encounter and have to resolve during the sedation of obese patients. Nasal high-flow systems (NHFS) are a new type of device that can supply warmed and humidified oxygen at a high flow rate (up to 50 L/min). In a recent study, the use of a NHFS was shown to prevent hypoxia during dental sedation. We hypothesized that the effects of NHFS use during sedation might be more significant in obese patients and employed a NHFS during dental sedation in obese patients. In this retrospective study, we investigated whether NHFS use improves oxygenation in obese patients during dental sedation.
Methods: We enrolled obese patients (body mass index >30) who underwent dental sedation using a NHFS at the Department of Dental Anesthesiology of Okayama University Hospital. From the patients’ anesthetic records, we compared the mean SpO₂ and minimum SpO₂ values obtained for the same patients during dental sedation with and without the NHFS.
Results: There were 5 obese patients who underwent dental sedation using a NHFS. During sedation without the NHFS, the mean SpO₂ was 94.8±1.1%, and the minimum SpO₂ was 89.6±3.8%. However, during sedation with the NHFS, the mean SpO₂ was 97.4±1.7%, and the minimum SpO2 was 95.6±1.8%. Both the mean SpO₂ and minimum SpO₂ were significantly higher during sedation with the NHFS.
Conclusions: Our results suggest that NHFS keep obese patients oxygenated, and hence, contribute to their safe management during dental sedation.