Journal article
The routine use of nasopharyngeal airway in the setting of monitored anesthesia care during gastrointestinal endoscopy: A multi-center single blinded randomized controlled trial
PloS one, Vol.21(6), e0349946
06/03/2026
DOI: 10.1371/journal.pone.0349946
PMCID: PMC13232847
PMID: 42234627
Abstract
Monitored anesthesia care (MAC) is commonly used for gastrointestinal (GI) endoscopy, allowing patients to breathe spontaneously while sedated. Despite its benefits, MAC is associated with respiratory adverse events, such as desaturation or the need for interventions. Limited studies have examined the effectiveness of nasopharyngeal airways (NPA) in reducing airway maneuvers and improving respiratory stability during MAC. The study evaluates the efficacy and safety of NPA in reducing the occurrence of at least one airway intervention/desaturation in patients undergoing GI endoscopy under MAC.
This multi-center, single-blinded randomized controlled trial involved patients undergoing GI endoscopy under MAC. A total of 329 patients were randomly assigned to either the NPA or control group. Primary outcomes included a composite primary outcome: occurrence of at least one airway intervention/desaturation. Secondary outcomes included adverse events, satisfaction scores of patients and healthcare providers, and the joint effects of NPA use and OSA risk on the occurrence of at least one airway intervention or desaturation.
The NPA group showed significantly lower incidence of occurrence of at least one airway intervention/desaturation compared to controls (18.5% vs. 40.1%, P < 0.001). NPA significantly reduced the occurrence of at least one airway intervention/desaturation in both low and intermediate/high risk OSA groups. The reduction was stronger in low OSA risk group (OR=0.23, 95%CI [0.11-0.49]) versus intermediate/high OSA risk group (OR=0.45, 95%CI [0.21-0.95]. Health care provider satisfaction was significantly higher in the NPA group (p < 0.001). Mild, self-resolving epistaxis occurred in 3.1% of NPA patients.
NPA use reduces airway interventions and enhances satisfaction among anesthesiologists and gastroenterologists during GI endoscopy under MAC. Routine utilization of NPAs in this context may be considered.
Details
- Title: Subtitle
- The routine use of nasopharyngeal airway in the setting of monitored anesthesia care during gastrointestinal endoscopy: A multi-center single blinded randomized controlled trial
- Creators
- Christian Raphael - American University of Beirut Medical CenterNancy Abou Nafeh - American University of Beirut Medical CenterMarc Moukarzel - American University of Beirut Medical CenterThuraya HajAli - American University of Beirut Medical CenterEliane Alhalabi - American University of Beirut Medical CenterAliyya Dabbous - American University of Beirut Medical CenterRaji Naamani - American University of Beirut Medical CenterPatrick Maroun - American University of Beirut Medical CenterYasser Sheib - American University of Beirut Medical CenterMarie T Aouad - American University of Beirut Medical CenterRony Al Nawwar - University Medical Center Rizk Hospital
- Resource Type
- Journal article
- Publication Details
- PloS one, Vol.21(6), e0349946
- DOI
- 10.1371/journal.pone.0349946
- PMID
- 42234627
- PMCID
- PMC13232847
- NLM abbreviation
- PLoS One
- ISSN
- 1932-6203
- eISSN
- 1932-6203
- Publisher
- Public Library of Science
- Grant note
- Medical Practice Plan at the American University of Beirut
The study was supported by the Medical Practice Plan at the American University of Beirut. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
- Language
- English
- Date published
- 06/03/2026
- Academic Unit
- Anesthesia
- Record Identifier
- 9985175261402771
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