Oxygen reserve index monitoring reduced the incidence of low pulse oxygen saturation during deep sedation for hysteroscopy: a prospective randomized controlled trial
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Objective Low pulse oxygen saturation (SpO 2 ) during deep sedation for hysteroscopy was common, which was a barrier for sedation performance. This randomized controlled trial tested whether oxygen reserve index (ORI) monitoring could reduce the incidence of low SpO 2 during deep sedation for hysteroscopy. Methods Based on whether ORI monitoring was adopted or not, and the oxygen supply methods during procedure [through face mask (FM) or nasopharyngeal airway (NPA)], four hundred participants underwent hysteroscopy under deep sedation were randomly divided into ORI+FM group, ORI+NPA group, non-ORI+FM group, and non-ORI+NPA group in a 1:1:1:1 ratio. Assist ventilation was performed when ORI dropped to zero in ORI monitoring groups, it was performed when SpO 2 dropped to 98% in non-ORI monitoring groups. The incidence of low SpO 2 , which defined as SpO 2 less than 95% during procedure, was compared. Results Compared to non-ORI monitoring groups, the incidence of low SpO 2 was lower (18% (95%CI: 0.103–0.257) and 21.4% (95%CI: 0.132–0.297) vs. 70.4% (95%CI: 0.612–0.796) and 51.5% (95%CI: 0.415–0.615), P < 0.001), average duration of assist ventilation (18 [0–35] and 15 [0–33] s vs. 36 [16–55] and 27 [0–53] s, P < 0.001) and time-weighted average duration of assist ventilation (0.016 [0–0.021] and 0.008 [0–0.016] vs. 0.022 [0.011–0.027] and 0.015 [0–0.025], P < 0.001) were shorter, the lowest SpO 2 value during procedure was higher (98 [96–99] and 97 [96–99] vs. 93 [91–97] and 94 [92–99], P < 0.001) in ORI monitoring groups (data ordered as ORI+FM, ORI+NPA, non-ORI+FM, and non-ORI+NPA group). The absolute risk reduction between ORI monitoring groups and non-ORI monitoring groups was 0.41 (41%) (95%CI: 0.322–0.498), the NTT was 3. Compared to FM, NPA could induce mild to moderate sore throat and mild airway injury. Conclusion During deep sedation for hysteroscopy, ORI monitoring and the altered clinician behavior from it may related to the reducing of the incidence of low SpO 2 and ensure oxygenation in low-to-moderate risk outpatients. Clinical trial registration https://clinicaltrials.gov/search?term=NCT05701839 , identifier NCT05701839.
Source: Frontiers in Medicine
Authors: Zheng Guan, Xin Li, Lin Liu, Jingjie Liu, Yanfeng Gao
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7130422452