{
    "abstract": "The provision of comfortable and safe environment for painless gastroscopy in obese patients is an urgent clinical problem. This study aimed to determine the efficacy and safety of the novel Li anesthetic protocol for obesity (LAPO) which included remifentanil-propofol regimen, manual right hypochondrial compression (MRHC), easy-to-create mask, and jaw thrust at preoperative painless gastroscopy in obese patients.\nThis prospective, single-center, single-arm trial recruited 106 participants underwent LAPO for gastroscopy. The primary outcome was the incidence of hypoxemia (peripheral oxygen saturation [SpO\nThe 98 obese patients under LAPO, the median body mass index (BMI) was 39.2 kg/m\nCompared with CAPO, LAPO reduced the incidence of hypoxemia from 40.4% to 27.5%, so, LAPO was safe and effective for painless gastroscopy. The finding might provide some new schedules for anesthetic management in the absence of advanced airway support instruments.\nChiCTR2300077889.\nWith the advancement of comfortable-oriented medication, gastroscopy is mostly performed under sedation and anesthesia. However, for obesity, there are changes in airway anatomy structure such as short neck, round chin, and large tongue, which makes them prone to airway obstruction after sleep or anesthesia, blocking the passage of oxygen in and out, which will cause hypoxemia over time and further cause damage to the body. Therefore, it is necessary to explore a safe and effective anesthesia management for painless gastroscopy in obesity. Our team\u2019s work demonstrates that the novel Li anesthetic protocol (strategic anesthesia management of remifentanil combined with propofol and effective respiratory support through MRHC and jaw thrust, increased oxygen reserve via a novel mask) for obesity for painless gastroscopy with lacking advanced airway management devices is safe and efficient. Furthermore, our findings contribute to the understanding of the lowest SpO",
    "authors": [
        {
            "affiliation": "Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China.",
            "firstname": "Mengxia",
            "initials": "M",
            "lastname": "Wang"
        },
        {
            "affiliation": "Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China.",
            "firstname": "Jieke",
            "initials": "J",
            "lastname": "Tang"
        },
        {
            "affiliation": "Department of Digestive Endoscopy Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China.",
            "firstname": "Zhaojie",
            "initials": "Z",
            "lastname": "Pan"
        },
        {
            "affiliation": "Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China.",
            "firstname": "Hongxue",
            "initials": "H",
            "lastname": "Jiang"
        },
        {
            "affiliation": "Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China.",
            "firstname": "Donghua",
            "initials": "D",
            "lastname": "Hu"
        },
        {
            "affiliation": "Department of Digestive Endoscopy Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China.",
            "firstname": "Beibei",
            "initials": "B",
            "lastname": "Zhu"
        },
        {
            "affiliation": "Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China.",
            "firstname": "Zhaojia",
            "initials": "Z",
            "lastname": "Liang"
        },
        {
            "affiliation": "Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China.",
            "firstname": "Xiangfeng",
            "initials": "X",
            "lastname": "Zhao"
        },
        {
            "affiliation": "Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China.",
            "firstname": "Yalan",
            "initials": "Y",
            "lastname": "Li"
        }
    ],
    "conclusions": "Compared with CAPO, LAPO reduced the incidence of hypoxemia from 40.4% to 27.5%, so, LAPO was safe and effective for painless gastroscopy. The finding might provide some new schedules for anesthetic management in the absence of advanced airway support instruments.",
    "copyrights": "\u00a9 2025 Wang et al.\n\u00a9 2025 Wang et al.",
    "doi": "10.2147/DDDT.S498238\n10.1111/dom.14290\n10.1016/j.apsb.2023.01.012\n10.1007/s13679-020-00422-w\n10.37765/ajmc.2022.89292\n10.1016/j.bjae.2021.12.007\n10.2147/dddt.S391147\n10.1136/gutjnl-2023-330396\n10.1016/j.bja.2021.03.020\n10.1007/s12630-020-01737-x\n10.3748/wjg.v26.i43.6867\n10.1111/den.13882\n10.1136/bmjgast-2021-000688\n10.5946/ce.2020.057\n10.1007/s00134-020-06312-y\n10.1093/bja/aex091\n10.1016/j.jclinane.2022.111042\n10.1016/j.bja.2021.01.028\n10.1213/ANE.0000000000006447\n10.2147/DDDT.S408076\n10.1080/10543406.2022.2058529\n10.1016/j.bjae.2020.07.003\n10.1067/mge.2003.207\n10.1080/07853890.2022.2134586\n10.1097/ALN.0000000000001407\n10.1186/s13613-020-00744-x\n10.1186/s13054-021-03738-8\n10.1016/j.sleep.2021.03.024\n10.1016/j.smrv.2023.101774\n10.1016/j.smrv.2023.101843\n10.1007/s11695-022-06038-4\n10.1186/1465-9921-12-80\n10.1007/s11325-017-1500-y\n10.1007/s11325-020-02241-8\n10.1007/s11695-018-3573-5\n10.1186/s12871-023-02075-3\n10.4103/0970-9185.125707",
    "journal": "Drug design, development and therapy",
    "keywords": [
        "compression",
        "hypoxemia",
        "obese patient",
        "obstructive sleep apnea",
        "painless gastroscopy",
        "propofol",
        "remifentanil"
    ],
    "methods": null,
    "publication_date": "2025-02-17",
    "pubmed_id": "39959120\n33621415\n37425065\n33410104\n36525676\n35614907\n36506792\n37816587\n33933271\n32514693\n33268967\n33124106\n36572454\n33730777\n33201321\n28974061\n36549036\n33685636\n37010960\n37168489\n35604836\n33456923\n12709693\n36269026\n27811485\n32990864\n34454546\n33887555\n37028145\n37683555\n35396662\n21676224\n28396972\n33201370\n30411226\n37069514\n24574597",
    "results": "The 98 obese patients under LAPO, the median body mass index (BMI) was 39.2 kg/m",
    "title": "Prospective Single-Arm Study of Remifentanil-Propofol Anesthesia with Manual Right Hypochondrial Compression for Painless Gastroscopy in Obese Patients.",
    "xml": "<Element 'PubmedArticle' at 0x788504a6af20>"
}