The configuration of interventional radiology (IR) suites often limits simultaneous access to the patient’s airway and anesthesia equipment. This constraint may lead to suboptimal sedation in patients at increased risk of airway obstruction due to patient safety concerns. We conducted a randomized pilot trial to evaluate whether high-flow nasal oxygen (HFNO; F SoC group: n = 51). Mean ToLDE time was 0.34 min (median, 0; range 0–6.5 min) in the HFNO group and 0.97 min (median, 0; range 0–19.8 min) in the SoC group ( P = 0.158). Desaturation occurred in 14% of HFNO patients vs. 26% of SoC patients ( P = 0.212). The median number of BIS excursions was significantly higher in the SoC group (4; range, 0–19) than the HFNO group (2; range, 0–15; P = 0.005). Median PACU stay was shorter in the HFNO group (20 min; range, 0–60) vs. in the SOC group (26 min; range, 5–60) ( P = 0.076). Patient-reported symptoms were less frequent and less severe in the HFNO group (12% vs. 16%). HFNO did not significantly reduce hypoxic events compared with a standard non-rebreather oxygen delivery device in patients at increased risk of airway obstruction during deep intravenous sedation. However, HFNO was associated with improved sedation stability and patient experience, supporting further investigation in larger studies. ClinicalTrials.gov ID: NCT04171037; Date of original registration: November 19, 2019; This study was retrospectively registered. Study principal investigator: Gang Zheng; This manuscript adheres to the applicable Consolidated Standards of Reporting Trials (CONSORT) guidelines.
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