Capnography Detection Using Nasal Cannula is Superior to Modified Nasal Hood in an Open Airway System: a Randomized Controlled Trial

Publication date: Available online 12 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Brett J. King, Andrew Megison, Zach Scogin, Brian J. Christensen

Purpose

The nasal cannula and modified nasal hood are both methods used by oral and maxillofacial surgeons to detect expired carbon dioxide during procedural sedation in an open airway system. The purpose of this study is to compare the accuracy of the detection of expired carbon dioxide between the nasal cannula and modified nasal hood.

Methods

The authors designed a parallel group, randomized controlled trial to compare the nasal cannula and modified nasal hood. Patients presenting to the author's institution for outpatient oral and maxillofacial surgery (OMS) utilizing IV deep sedation/general anesthesia were randomized to have capnography detection by either the modified nasal hood or the nasal cannula. The primary outcome variable was the percent of accurately captured breaths, as determined by the average number of capnography waveforms per auscultated breaths using a precordial stethoscope. The two groups were compared using a t-test.

Results

A total of 50 patients were screened for enrollment in the study. There were 25 patients randomized to the nasal cannula group and 25 patients randomized to the modified nasal hood group. The number of accurate waveforms, as recorded as a percent of total breaths, was 95.7% ± 4.7% for the nasal cannula and 75.8% ± 14.1% for the modified nasal hood (p<0.0001).

Conclusions

When used for capnography for procedural sedation in an open airway system for routine OMS, the nasal cannula accurately recorded more breaths than the modified nasal hood.

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