Comparative efficacy of NO-DESAT and THRIVE for peri-oxygenation in patients with anticipated difficult airway.

Background and Aims: Pre-oxygenation followed by "apnoeic oxygenation" is an effective strategy for prolonging the safe duration of apnoea. This study aimed to compare the efficacy of nasal oxygen during efforts securing a tube (NO-DESAT) and transnasal humidified rapid insufflation ventilatory exchange (THRIVE) for oxygenation, ventilation, patient comfort, and cost of oxygen consumed in patients with anticipated difficult airway. Methods: After obtaining institutional ethics committee approval, 40 consenting adult patients with American Society of Anesthesiologists (ASA) physical status I-III scheduled for surgery under general anaesthesia with anticipated difficult airway were recruited. They received facemask pre-oxygenation at 10 L/min till laryngoscopy in addition to nasal oxygen through a simple nasal cannula at the rate of 15 L/min (group N) or THRIVE at 30 L/min for one minute followed by 60 L/min until intubation (group T). Arterial samples were drawn at baseline, after pre-oxygenation and intubation. The primary outcome was the partial pressure of oxygen (PaO Results: Mean PaO Conclusion: Both NO-DESAT and THRIVE are equally efficacious for peri-oxygenation. However, NO-DESAT should be preferred for its cost-effectiveness.