Comparison of preoxygenation with a high-flow nasal cannula and a simple mask before intubation during induction of general anesthesia in patients undergoing head and neck surgery: Study protocol clinical trial (SPIRIT Compliant)

Abstract

Background: To assess the arterial oxygen partial pressure (PaO2) at defined time points during preoxygenation and to compare high-flow heated humidified nasal oxygenation with standard preoxygenation using oxygen insufflation via a facemask for at least 5 minutes, before intubation during induction of general anesthesia.

Methods: This randomized, single-blinded, prospective study will be conducted in patients undergoing head and neck surgery. After standard monitoring, the artery catheter at the radial artery or dorsalis pedis artery will be placed and arterial blood gas analysis (ABGA) for baseline values will be performed simultaneously. Each group will be subjected to 1 of 2 preoxygenation methods (high-flow nasal cannula or simple facemask) for 5 minutes, and ABGA will be performed twice. After confirming intubation, we will start mechanical ventilation and check the vital signs and perform the final ABGA.

Discussion: This trial aims to examine the trajectory of PaO2 levels during the whole preoxygenation procedure and after intubation. We hypothesize that preoxygenation with the high-flow nasal cannula will be superior to that with the face mask.

Study registration: This trial was registered with the Clinical Trial Registry (NCT03896906; ClinicalTrials.gov).

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1

Flow diagram of the study, ∗Data: arterial systolic, diastolic, and mean blood pressure, heart rate, and SpO2, T0 = pre-induction baseline, T3 = at second tidal volume, under mechanical ventilation after intubation, ABGA = arterial blood gas analysis, SpO2 = oxygen saturation, T1 = 2 minutes after preoxygenation, T2 = 5 minutes after preoxygenation.