Efficacy of nasal clips combined with nasal cannulas in preventing hypoxemia during gastrointestinal endoscopy with sedation: a randomized controlled trial.
Summary
In 600 sedated endoscopy patients, adding nasal clips to standard nasal cannula oxygen significantly reduced hypoxemia incidence versus cannula alone (17.7% vs 25%; RR 0.707). The lowest SpO2 improved and adverse events were tolerable, supporting a simple, low-cost intervention to enhance periprocedural oxygenation.
Key Findings
- Hypoxemia incidence decreased from 25.0% to 17.7% with nasal clips (RR 0.707, 95% CI 0.516–0.967, P=0.029).
- Lowest SpO2 during the procedure improved in the nasal clip group (median and IQR improved; details reported by authors).
- Adverse events were tolerable without excess complications compared to cannula alone.
Clinical Implications
Adopt nasal clips with nasal cannula oxygen during sedated endoscopy—especially in patients at risk of hypoxemia—to reduce desaturation events and improve nadir SpO2.
Why It Matters
Large randomized evidence for a widely applicable, low-cost modification that improves safety during sedated endoscopy, a high-volume anesthetic practice.
Limitations
- Single-country study; sedation regimens and oxygen flow settings may affect generalizability
- Blinding likely not feasible, which could influence ancillary care
Future Directions
Evaluate effectiveness across different sedation protocols, high-risk populations (OSA, obesity), and cost-effectiveness analyses to inform widespread adoption.
Study Information
- Study Type
- RCT
- Research Domain
- Prevention
- Evidence Level
- I - Randomized controlled trial with 600 adults undergoing sedated endoscopy
- Study Design
- OTHER