What does this research mean for the field?

Nasal high flow respiratory support significantly reduces opioid requirements while maintaining adequate oxygenation and ventilation during endoscopic retrograde cholangiopancreatography under dexmedetomidine-based sedation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate whether nasal high flow therapy reduces opioid requirements compared with low-flow oxygen in patients undergoing endoscopic retrograde cholangiopancreatography under dexmedetomidine-based sedation.

September 5, 2026DEN OpenOpen Access

Respiratory Support With Nasal High Flow Reduces Opioid Requirements During Endoscopic Retrograde Cholangiopancreatography

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Authors

TMTomotaka MoriJapanese Red Cross Society, Japan TATakao AyuseNagasaki University Hospital SSShuntaro SatoNagasaki University Hospital

Discussion

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Implication

Randomized trial demonstrates nasal high flow reduces opioid requirements in patients undergoing ERCP, highlighting enhanced respiratory stability during procedural sedation.

Key Points

To evaluate whether nasal high flow therapy reduces opioid requirements compared with low-flow oxygen in patients undergoing endoscopic retrograde cholangiopancreatography under dexmedetomidine-based sedation.
Open-label, single-center randomized controlled trial enrolling 94 patients (NHF: n=47, LFO: n=47; trial registration: jRCTs 072210047) after early termination due to slow recruitment.
Patients received standardized sedation with dexmedetomidine, midazolam, and pethidine, with total pethidine dose as the primary endpoint.
Nasal high flow significantly decreased overall opioid requirements compared to low-flow oxygen (incidence rate ratio: 0.77, 95% CI: 0.62–0.96, p = 0.023).
Median total pethidine dose was significantly lower in the nasal high flow group than in the low-flow oxygen group (43.75 mg vs. 70.00 mg, p = 0.004).
Processed electroencephalography revealed a lower patient state index and electromyographic activity in the nasal high flow group indicating deeper sedation, while transcutaneous carbon dioxide and oxygenation-perfusion parameters did not differ significantly between groups.

Cite This Study

Mori et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd49d6b95aff0620ec748 https://doi.org/10.1002/deo2.70421

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Implication

Randomized trial demonstrates nasal high flow reduces opioid requirements in patients undergoing ERCP, highlighting enhanced respiratory stability during procedural sedation.

Respiratory Support With Nasal High Flow Reduces Opioid Requirements During Endoscopic Retrograde Cholangiopancreatography

Discussion

Member takes

Implication

Key Points

Cite This Study

Respiratory Support With Nasal High Flow Reduces Opioid Requirements During Endoscopic Retrograde Cholangiopancreatography

Discussion

Member takes

Implication

Key Points

Cite This Study

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