Abstract: Objective To study the use of transnasal humidified rapid insufflation ventilatory exchange(THRIVE)ventilation technology in bronchofiberoscopy under general anesthesia. Methods A total of 32 patients requiring bronchoscopy under general anesthesia at The Second Hospital of Shandong University between August 2022 and May 2023 were selected for this study. Each received atomizing inhalation of local anesthesia, after which bronchofiberoscopy was initiated under general anesthesia. Arterial blood samples were collected for blood gas analysis before the anesthesia was administered and during the recovery period following each procedure. The total anesthesia time was recorded. The patients were followed up with on the next day after the procedure. Results No intraoperative or postoperative complications were observed in any of the 32 patients. Among them, five patients(four of whom snored)were switched to low-minute volume owing to oxygen desaturation. The average anesthesia time of the remaining 27 patients was 20.75±6.70 minutes. Oxygen partial pressure(SpO₂)was maintained above 95% throughout the procedure. The postoperative SpO₂ values were slightly higher than the preoperative ones, although the difference was not statistically significant. No significant correlation was identified between SpO₂ and total anesthesia time. Carbon dioxide partial pressure(SPCO₂)and total CO₂ were significantly increased following the administration of the anesthesia. However, PH was significantly reduced. Both the increase in SPCO₂ and the decrease in PH were positively correlated with the duration of the anesthesia. No significant differences were observed in terms of BE values. Conclusion THRIVE carries certain advantages for bronchofiberoscopy procedures performed under general anesthesia-particularly in terms of providing sufficient oxygen to the patient. Moreover, THRIVE can also make the procedure convenient and comfortable for the patient, without causing any obvious complications. However, certain limitations to the use of THRIVE exist. Patients with stenosis in their airways, such as those who snore, often cannot achieve a satisfactory apnea time. This technique may lead to CO₂ accumulation, which can limit the time available to complete the procedure. With much interest, we await the development of new techniques to adequately remove CO₂ from the lungs, which may lead to a wide adoption of THRIVE.

Key words: Transnasal humidified rapid insufflation ventilatory exchange, General anesthesia, Bronchofiberscope, Arterial blood gas analysis