[Evaluation of transnasal humidified rapid-insufflation ventilatory exchange technology in rigid esophagoscopy for foreign body removal under general anesthesia].

<b>Objective:</b> To explore the efficacy of transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) technology in rigid esophagoscopy for foreign body removal under general anesthesia. <b>Methods:</b> Patients who underwent rigid esophagoscopy for foreign body removal under general anesthesia from September to December 2022 at Beijing Tongren Hospital were prospectively included. After entering the operating room, all patients received high-flow oxygen for 5 minutes, with an inhaled temperature of 37 ℃, an oxygen concentration of 100%, and an oxygen flow rate of 30 L/min. After anesthesia induction, the oxygen flow rate was adjusted to 60-80 L/min until the patients awoke. The primary outcome was the success rate of THRIVE defined as percutaneous oxygen saturation (SpO₂)≥95% throughout anesthesia, while the safety outcome was the incidence of complications associated with THRIVE. The operation time, apnea time, anesthesia duration, heart rate, mean arterial pressure, and SpO₂ were recorded at the following time points,such as entering the operating room (T0), after 5 minutes of high-flow oxygenation (T1), post-anesthesia induction (T2), during esophagoscope insertion (T3), at the end of the procedure upon esophagoscope withdraw (T4), upon awakening (T5), and upon exiting the operating room (T6). <b>Results:</b> Fifty patients (17 males and 33 females) were enrolled, with an age of (54.0±20.5). The success rate of THRIVE technology was 86%(43/50). A total of 7 patients required airway intervention, among which 6 patients underwent mask compression ventilation and 1 patient underwent endotracheal intubation intraoperatively. Three cases occurred before the end of esophagoscopy and required interruption of esophagoscopy for airway intervention. No complications related to THRIVE technology were observed. The heart rate of all patients was (86±12) beats/min at T6, which was significantly higher than that of (79±15) beats/min at T2 (<i>P</i><0.001). The mean arterial pressure (MAP) was (90.4±13.3) mmHg (1 mmHg=0.133 kPa) at T2, which were significantly lower than that of (105.5±14.2) mmHg at T0 and (102.0±13.7) mmHg at T1. The mean arterial pressures at T4 and T5 were (84.8±15.0) and (82.9±14.5) mmHg, respectively, which were significantly lower than the (90.4±13.3) mmHg at T2 (all <i>P</i><0.001). No cardiovascular or respiratory adverse events occurred during the procedure or the postoperative recovery monitoring period. <b>Conclusion:</b> THRIVE technology can be safely and effectively applied in rigid esophagoscopy for foreign body removal under general anesthesia, providing effective oxygenation, and maintaining stable circulation.