Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2020.04.019
Brazilian Journal of Anesthesiology
Clinical Research

New oropharyngeal double lumen cannula for sedation for transesophageal echocardiography: case series

Nova cânula orofaríongea de duplo lúmen para sedação em ecocardiografia transesofágica: série de casos

Caetano Nigro Neto, Francisco José Lucena Bezerra, Rodrigo Bellio de Mattos Barreto, Davi Costa de Souza Le Bihan, Vinicius Tadeu Nogueira da Silva do Nascimento, Ingrid Caroline Baia de Souza

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Abstract

Introduction
Currently, transesophageal echodopplercardiography (TEE) is frequently performed under sedation on an outpatient basis. Sedation is related with increase in incidents on airways. Bearing in mind this scenario, we developed a new double lumen oropharyngeal cannula aimed at keeping airway patency, in addition to reducing risks to patients during endoscopy procedures performed under sedation. The main objective of our study was to assess the incidence of oxygen desaturation in a series of cases of adult patients submitted to outpatient TEE exam, under sedation and using the oropharyngeal cannula.

Method
30 patients under sedation with intravenous midazolam and propofol were assessed. After loss of consciousness, the cannula was placed and patients were maintained on spontaneous breathing. Oxygen saturation, capnometry, heart rate and non-invasive arterial blood pressure, in addition to subjective data: airway patency, handling of cannula insertion and, comfort of examiner were analyzed.

Results
The incidence of mild desaturation was 23.3%, and there was no severe desaturation in any of the cases. The insertion of the oropharyngeal cannula was considered easy for 29 patients (96.6%), and TEE probe handling was appropriate in 93.33% of exams performed.

Conclusions
TEE exams under sedation aided by the double-lumen oropharyngeal cannula presented a low incidence of desaturation in patients assessed, and allowed analysis of expired CO2 during the exams.

Keywords

Double lumen cannula;  Transesophageal echocardiography;  Sedation;  Ambulatory anesthesia;  Spontaneous ventilation

Resumo

Introdução
Nos dias atuais, exames de ecocardiografia transesofágica (ETE) são realizados de forma frequente sob sedação em regime ambulatorial. A sedação está relacionada com aumento de intercorrências nas vias aéreas. Dentro deste contexto, desenvolvemos uma cânula orofaríngea de duplo-lúmen com finalidade de manutenção da via aérea pérvia, reduzindo riscos aos pacientes durante procedimentos endoscópicos sob sedação. O principal objetivo do nosso estudo foi avaliar a incidência de dessaturação em uma série de casos de pacientes adultos submetidos à ETE ambulatorial sob sedação com o uso da cânula orofaríngea.

Métodos
Foram avaliados 30 pacientes sedados com midazolam e propofol intravenoso. A cânula foi inserida após perda da consciência e os pacientes foram mantidos com ventilação espontânea. Analisados saturação de oxigênio, capnometria, frequência cardíaca e pressão arterial não invasiva, além de dados subjetivos: patência das vias aéreas, manuseio e inserção da cânula e, conforto ao examinador.

Resultados
A incidência de dessaturação leve foi de 23.3% e, não houve dessaturação grave em nenhum caso. A inserção da cânula orotraqueal foi considerada fácil em 29 pacientes (96,6%) e o manuseio da sonda de ETE foi adequada em 93,33% dos exames realizados.

Conclusões
A realização dos exames de ETE sob sedação com auxilio da cânula orofaríngea de duplo lúmen apresentou baixa incidência de dessaturação nos pacientes avaliados, além de permitir análise do CO2 expirado durante a realização dos exames

Palavras-chave

Cânula de duplo lúmen;  Ecocardiografia transesofágica;  Sedação;  Anestesia ambulatorial;  Ventilação espontânea

References

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