HFNC and Hypoxia During Percutaneous Radiofrequency Ablation Under Conscious Sedation: A Randomized Clinical Trial

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    Zhejiang Cancer Hospital
Updated on 27 November 2022


Background: Propofol based sedated anesthesia was widely used in percutaneous radiofrequency ablation and hypoxia is one of the most frequent adverse events during this procedure. No effective methods have been found to prevent hypoxia so far. The aim of this study was to evaluate whether the incidence of hypoxia was different under high-flow nasal cannula (HFNC) therapy, which can provide heated and humidified oxygen up to 60L/minute.

Methods: In a randomized, prospective and double-blind study, 318 patients undergo percutaneous radiofrequency ablation based on propofol sedation were assigned into two groups: the nasal cannula group (O2 [6 L/minute] was supplied via an HFNC) and the HFNC group (O2 [40 L/minute] was supplied via an HFNC). The primary outcome is the incidence of hypoxia during surgery. Other adverse events were also recorded.


After received the approvement of ethics committee of the Cancer Hospital of the University of Chinese Academy of Sciences (approval number IRB-2022). The study was registered before patient enrollment in Clinicaltrials.Written informed consent was obtained from all participants. The study was performed from Feb 1,2022 to August 31, 2022. 100 adult gastric cancer patients between 18-75 years, ASA physical state I and II, undergoing percutaneous radiofrequency ablation, were enrolled in this study.

Preoperative arrangements 3-lead electrocardiogram, pulse oximetry and non-invasive blood pressure were measured for basic monitoring. Local anaesthesia was induced by administering 7 ml of 2% lidocaine before the ablation needle was first inserted into the tumour. Then, 0.15 mg/kg oxycodone (diluted to 1 mg/ml with normal saline; Mundipharma, Vantaa, Finland) was administered to both groups. Rescue opioids were administered when the numerical rating scale (NRS) score was greater than 4 or when the patient had obvious, unwanted body movements. The rescue OXY dose was 0.05 mg/kg with the total dose not to exceed 0.25 mg/kg. Blood pressure was measured every 3 minutes as well as 2 minutes after the drug was administered or at the discretion of the anaesthesiologist. All patients remained in the PACU under monitoring for at least 30 minutes until their Aldrete score was between 9 to 10. Mean blood pressure, heart rate, and respiratory rate were recorded. The effect site concentration of propofol is 1.3 ug/ml at the beginning and adjusted at a stepwise of 0.3 ug/ml to maintain a sedation score between 3-4. The depth of sedation was assessed and recorded every 3 minutes by OAA/S.

Condition Propofol Syndrome, Hypoxia, Sedation Complication
Treatment high-flow oxygen nasal cannula therapy, nasal cannula oxygen therapy, nasal cannula oxygen therapy
Clinical Study IdentifierNCT05212064
SponsorZhejiang Cancer Hospital
Last Modified on27 November 2022

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