This research is an observational prospective case-control study conducted in the Burns
Center of Ankara Bilkent City Hospital. The aim of the study was to compare standard
nasal oxygen therapy with High Flow Nasal Oxygen (HFNO) therapy in terms of hypoxemia in
patients undergoing surgery for minor and moderate burns under deep sedation. Volunteer
patients over 18 years of age, in the ASA (American Society of Anesthesiology) I-III risk
group, who will undergo burn operation will be included in the study. Patients will be
informed about the scope of the study, possible risks and benefits before participating
in the study, and informed consent will be obtained from all participants by signing the
informed consent form.
A total of 70 patients will be included in the study. The study consists of 2 groups.
Group 1: Standard nasal oxygen (n:35), Group 2: HFNO (n:35) Before starting induction,
patients who will be given nasal oxygen will be preoxygenated with 100% oxygen for 3 min
with an oxygen flow rate of 8 l/min. Patients who will receive HFNO will be preoxygenated
with HFNO 40 l/min with FiO2 100% 3 min before induction. Patients will be premedicated
with 1 mg iv midazolam and 1 mcg/kg fentanyl 1 min before induction. During the induction
phase, 1% propofol-ketamine (0.5-1 mg/kg) will be administered and an additional dose of
propofol-ketamine will be administered according to the patient's BIS value and the total
drug dose will be noted. Non-invasive arterial blood pressure, heart rate,
electrocardiogram (ECG), oxygen saturation, SpO2, BIS and NIRS values will be recorded
before and every 5 minutes during the procedure. Patient demographics, total procedure
time, amount of anesthetic agent used, heart rate and other clinical parameters will also
be recorded. Ramsey sedation scale of the patients during the procedure and Aldrete
scores at the end of the procedure will be evaluated. In case of apnea or desaturation,
maneuvers such as patient stimulation, chin lifting, or increasing oxygen flow were
performed and recorded.
The statistical package program SPSS 25.0 (Armonk, NY: IBM Corp.) will be used for data
analysis. Descriptive statistics (frequency, percentage, minimum, maximum, mean, standard
deviation, median, min-max, IQR) will be used. Pearson chi-square test, Fisher or Yates
x2 tests will be used to compare qualitative data. The conformity of the data to normal
distribution will be evaluated by Kolmogorov-Smirnov and Shapiro-Wilk tests,
skewness-kurtosis and graphical methods (histogram, Q-Q Plot, Stem and Leaf, Boxplot).
For normally distributed quantitative data, independent samples t test or one way ANOVA
will be applied. For non-normally distributed data, Mann-Whitney U test or Kruskal-Wallis
test will be used. Paired t test or Friedman test will be used to compare repeated
measures. The relationship between variables will be evaluated by Pearson or Spearmans's
Rho Correlation test. P<0.05 will be accepted as statistical significance level.