High-flow oxygen delivery system and oxygen reserve index-guided apnoeic oxygenation versus low-tidal-volume ventilation during robotic flexible ureteroscopy: A retrospective cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background and Aims: Robotic flexible ureteroscopy often requires intermittent apnoeic periods to minimise kidney movement and improve surgical conditions. This study evaluated the effectiveness of high-flow oxygenation (HFO) in maintaining oxygenation and preventing desaturation during retrograde flexible ureteroscopy (RFU). Methods: This retrospective cohort study included 62 male patients undergoing robotic RFU: 28 received HFO and 34 served as controls. The HFO group underwent repeated 5-minute apnoeic periods with 100% oxygen delivered at up to 80 L/min. Vital parameters were recorded before and after each apnoeic period. In the control group, the tidal volume was reduced to 250 mL with a respiratory rate of 20 cycles per minute during the robotic phase, and these settings were maintained throughout. Wilcoxon rank-sum test, T-tests, and Fisher's exact test were used to compare the groups. Durbin-Conover test was used for pairwise comparisons. Results: < 0.001). No desaturation events or haemodynamic instability occurred in the HFO group. ORI and PI remained stable, and no postoperative complications were reported. Conclusion: HFO during robotic ureteroscopy appears effective in maintaining oxygenation and haemodynamic stability while providing a still surgical field. These findings support its integration into clinical practice for procedures requiring controlled apnoea.
Source: Indian Journal of Anaesthesia
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7130735031