The effect of jaw-thrust maneuver combined with gentle chest compression with right elbow to prevent hypoxemia in painless fiberoptic bronchoscopy

ZHANG Qiling; ZHANG XiaoQing; LI Yufang; TAN Hongbao; WU Di

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Journal of Hunan Normal University(Medical Science) ›› 2025, Vol. 22 ›› Issue (4) : 124-128.

The effect of jaw-thrust maneuver combined with gentle chest compression with right elbow to prevent hypoxemia in painless fiberoptic bronchoscopy

ZHANG Qiling¹, ZHANG XiaoQing¹, LI Yufang¹, TAN Hongbao¹, WU Di¹

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Abstract

Objective To explore the effect of Jaw-thrust maneuver combined with gentle chest compression with right elbow to prevent hypoxemia in painless fiberoptic bronchoscopy. Methods 120 patients who underwent painless fiberoptic bronchoscopy were randomly divided into two groups, 60 patients in each group: group B (Jaw-thrust maneuver with both hands) and group BT (Jaw-thrust maneuver with both hands combined with gentle chest compression on the right elbow). After the patient's consciousness disappeared, the group B was given Jaw-thrust maneuver with both hands (mandibular angle moved forward by 0.5-1cm), and the group BT was received Jaw-thrust maneuver and gentle chest compression with the right elbow (the compression range is 2-3cm, the frequency is 30 times per min, a total of 20 times). The total time of searching and passing glottis, the incidence of the decline of blood oxygen (SpO₂<basic value), hypoxia state (SpO₂<95%) and hypoxemia (SpO₂<90%) in each group were compared. Besides, we collected the ventilation rate of face mask and diaphragm activity (DE) in each group. Results The incidence of the decline of blood oxygen, hypoxia state and hypoxemia in the group BT was significantly lower than that in B group. The diaphragmatic activity of 2 min after injection of the group BT was significantly increased compared with group B. Conclusion The method of Jaw-thrust maneuver combined with gentle chest compression with right elbow can reduce the occurrence of hypoxemia in painless fiberoptic bronchoscopy and enhance the movement of diaphragm under sedation. It is a simple, safe and effective method which is worth popularizing.

Key words

fiberoptic bronchoscopy / hypoxemia / mandibular holding method / chest compression

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ZHANG Qiling, ZHANG XiaoQing, LI Yufang, TAN Hongbao, WU Di. The effect of jaw-thrust maneuver combined with gentle chest compression with right elbow to prevent hypoxemia in painless fiberoptic bronchoscopy[J]. Journal of Hunan Normal University(Medical Science). 2025, 22(4): 124-128

References

[1] CARON M, PARROT A, ELABBADI A, et al.Pain and dyspnea control during awake fiberoptic bronchoscopy in critically ill patients: safety and efficacy of remifentanil target-controlled infusion[J]. Ann Intensive Care, 2021, 11(1): 48.
[2] 卢怡君, 曹殿青. 无痛纤维支气管镜检查麻醉药物的研究进展[J]. 中国医学创新, 2023, 20(13): 183-188.
[3] JACOMELLI M, MARGOTTO S S, DEMARZO S E, et al.Early complications in flexible bronchoscopy at a university hospital[J]. J Bras Pneumol, 2020, 46(4): e20180125.
[4] 肖素琼, 付雄, 卢祥成, 等. 经鼻高频通气对无痛纤支镜气道管理的效果分析[J]. 中国临床医生杂志, 2018, 46(3): 3-5.
[5] 郭栋伟, 刘凌志, 张鹏飞. 经鼻咽通气道接高频喷射呼吸机用于无痛纤支镜检查的临床观察[J]. 临床医药文献电子杂志, 2018(81): 3-6.
[6] 吕静, 彭建良, 单立刚. 声门上喷射通气在低氧血症患者纤维支气管镜诊疗中的应用[J]. 中国医疗器械信息, 2021, 27(12): 4-6.
[7] LEE T H, LEE C K.Endoscopic sedation: from training to performance[J]. Clin Endosc, 2014, 47(2): 141-150.
[8] 杨雅涵, 管亦方, 张小峰. 吸氧结合托下颌法对行无痛胃镜治疗患者呛咳、呼吸抑制的改善作用[J]. 齐鲁护理杂志, 2022, 28(11): 62-64.
[9] 左小明, 李同, 王维林. 双手托下颌法对无痛胃镜检查的影响[J]. 吉林医学, 2019, 40(01): 41-43.
[10] 刘慧敏, 付卫东, 罗柳, 等. 亚麻醉剂量艾司氯胺酮联合应用丙泊酚对老年无痛肠镜检查患者苏醒质量及促炎因子的影响[J]. 湖南师范大学学报 (医学版), 2023, 20(05): 111-116.
[11] 边华光, 陈沁, 张玉光, 等. 不同剂量苯磺酸瑞马唑仑复合阿芬太尼用于无痛支气管镜检查的麻醉效果比较[J]. 浙江临床医学, 2025, 27(03): 431-432, 438.
[12] BARBOSA E C, ESPÍRITO SANTO P A, BARALDO S, et al. Remimazolam versus propofol for sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis[J]. Br J Anaesth, 2024, 132(6): 1219-1229.
[13] 周小涵, 庞巍, 李莹莹, 等. 浅谈“麻精药品”的药性和毒性[J]. 健康必读, 2024(18): 38.
[14] GOUDRA B, GOUDA G, SINGH P M.Recent Developments in Devices Used for Gastrointestinal Endoscopy Sedation[J]. Clin Endosc, 2021, 54(2): 182-192.
[15] KILIC E T, SAYAR S.Can Bispectral Index Monitoring (EEG) be an Early Predictor of Respiratory Depression under Deep Sedation during Endoscopic Retrograde Cholangiopancreatography?[J]. Sisli Etfal Hastan Tip Bul, 2020, 54(4): 444-450.
[16] 高丽雯, 郑重, 陆心仪, 等. 瑞马唑仑通过Akt/mTOR信号通路对CIRI大鼠脑神经元的保护作用[J]. 中南医学科学杂志, 2024, 52(06): 902-905.
[17] GOUDRA B, GOUDA G, MOHINDER P.Recent Developments in Drugs for GI Endoscopy Sedation[J]. Dig Dis Sci, 2020, 65(10): 2781-2788.
[18] 李娜, 杨明媛, 程庆好. 丙泊酚、依托咪酯分别联合瑞芬太尼靶控输注在无痛气管镜硬镜检查中的麻醉效果观察[J]. 湖南师范大学学报 (医学版), 2024, 21(02): 86-88, 97.
[19] Frat JP, Thille AW, Mercat A, et al.High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure[J]. N Engl J Med, 2021, 372(23): 2185-2196.
[20] 汪平娟, 江涛, 王义桥. 经鼻微旁流式监测PETCO₂在门诊无痛胃镜诊疗中对呼吸抑制的预警作用观察[J]. 齐齐哈尔医学院学报, 2024, 45(11): 1038-1042.
[21] 杨雪梅. 新型鼻罩式手法与托下颌手法在丙泊酚无痛胃镜中辅助通气的比较[D]. 长春: 吉林大学, 2023.
[22] UZUN L, UGUR MB, ALTUNKAYA H, et al.Effectiveness of the Jaw-Thrust Maneuver in Opening the Airway: A Flexible Fiberoptic Endoscopic Study[J]. ORL J Otorhinolaryngol Relat Spec, 2005, 67(1): 39-44.
[23] PARK D, KIM J, HEO S J.The Effect of the Modified Jaw-Thrust Maneuver on the Depth of Sedation During Drug-Induced Sleep Endoscopy[J]. J Clin Sleep Med, 2019, 15(10): 1503-1508.
[24] 阿尔达克·夏买提, 佘志佳, 朱联周. 胸外按压预防脾虚湿阻型肥胖患者无痛胃镜检查中的低氧血症临床观察[J]. 湖北中医药大学学报, 2020, 22(04): 81-84.
[25] 阿尔达克·夏买提, 魏靖茹, 陆天佑, 等. 胸腹按压对无痛胃镜患者丙泊酚镇静引起呼吸抑制的预防[J]. 中山大学学报 (医学科学版), 2022, 43(4): 631-638.
[26] ZHU M Y, CHEN X Q, HUANG F, et al.Effect of electroacupuncture on diaphragmatic function in patients with post-stroke tracheotomy[J]. Zhongguo Zhen Jiu, 2020, 40(3): 239-242.
[27] LIU X, YANG Y, JIA J.Respiratory muscle ultrasonography evaluation and its clinical application in stroke patients: A review[J]. Front Neurosci, 2023, 17: 1132335.
[28] 周叶子, 张阳普, 张伟, 等. 膈肌超声在脑卒中患者气管套管拔除中应用的临床观察[J]. 中国康复, 2024, 39(08): 494-497.
[29] 黄卫红, 姚志雄. 超声辅助评估肺部和膈肌功能对腹部手术患者术后呼吸功能的影响[J]. 岭南现代临床外科, 2025, 25(02): 127-134.