1. Introduction
hypoxemia, obstructive sleep aspiration syndrome, hypercapnia, anxiety
RESPIRATORY DISORDERS, CAVITY
In the case of endoscopic retrograde cholangiopancreatography (ERCP) and other relatively invasive examinations and procedures under upper gastrointestinal endoscopy, sedation is widely applied to relieve patient anxiety. In line with the recommended sedative drug described in Guideline released by Japan Gastroenterological Endoscopy Society,Therefore, how to prevent COOn the other hand, the applied effect of a device called Nasal High flow (hereinafter abbreviated as NHF) that inhales humidified high flow oxygen and air, which is one of the respiratory control methods, is attracting attention. The NHF load machine (trade name AIRVO3), which flows a high flow of oxygen from the nasal cavity, is used for patients with obstructive sleep aspiration syndrome and respiratory disorders, and has a mild positive pressure load (several cmHIn this study, we applied NHF as a respiratory management method to patients undergoing ERCP under sedation to prevent the onset of intraoperative hypercapnia and reduce the respiratory workload during sedation. The purpose is to examine whether sedation can be stabilized by reducing the arousal response.Although there are some studies on the prevention of hypoxemia by performing respiratory management using NHF during ERCP, there are no clinical trials in Japan or overseas to verify whether the sedative effect is stabilized. Upon completion of this study, patients will be able to receive ERCP treatment under safer, less stressful sedation.Objective: In this study, the Clinical Question asked, “Can NHF stabilize breathing and increase sedation under the same sedative dose?,” “Use NHF at the recommended doses of Dexmedetomidine and Midazolam?” The purpose of verifying the Research Question: Is there a difference in the total dose of pethidine hydrochloride, a concomitant analgesic, if the same SEDLINE sedation and Ramsay scale indicators (minimum and area under the curve [AUC]) are maintained in the group?Significance: If NHF can be used in combination during sedation with Dexmedetomidine and Midazolam to suppress the arousal response during sedation and stabilize the degree of sedation, the minimum amount of analgesic used with sedatives is necessary. We believe that limited administration of sedative drugs can provide a high-quality systemic management method with fewer side effects.