Table 1Patient characteristics.

Characteristic / NCO group (n=48) / WNJ group (n=46) / P-value
Age (yr) / 49.7 (10.3) / 50.0 (8.8) / 0.316
Male/female (%) / 26 (54.2)/22 (45.8) / 27 (58.7)/19 (41.3) / 0.676
Weight (kg) / 64.9 (10.2) / 63.9 (9.9) / 0.938
Height (cm) / 163.3 (9.3) / 163.3 (8.7) / 0.658
ASA class (I/II) / 36/12 / 30/16 / 0.300
Mallampati class (I/II) / 18/30 / 14/32 / 0.470

WNJgroup,propofol-lidocaine-remifentanil with supraglottic pulsatile jet oxygen and ventilation (SJOV)group;

NCO group: remifentanil with nasal cannula supplement oxygen.

Table 2Incidence of hypoxia and need for airway assistance.

Characteristic / NCO group (n=48) / WNJ group (n=46) / P-value
Desaturation / 13 (27.1) / 0 (0) / 0.000
Steps of airway assistance / 13 (27.1) / 2 (4.3)
Increase in oxygen flow / 0 (0) / 0 (0)
Verbal and tactilestimulation / 0 (0) / 0 (0)
Chin lift / 2 (4.2) / 2 (4.3)
Jaw thrust / 11 (22.9) / 0 (0)
Face mask and manual ventilation / 0 (0) / 0 (0)
change the depth of WNJ / - / 0
Rotate WNJ slightly / - / 0
Requirement of oral cavity suction / 13 (27.1) / 14 (30.4) / 0.720

Hypoxia was defined as SaO2 less than 90% for a duration of 10 seconds or greater.

WNJgroup,propofol-lidocaine-remifentanil with supraglottic pulsatile jet oxygen and ventilation (SJOV)group;

NCO group: remifentanil with nasal cannula supplement oxygen

Table 3Topical anesthesia during flexible bronchoscope andMOAA/S score.

MOAA/S score / NCO group (n=48) / WNJ group(n=46) / P-value
Requirements of topicalanesthesia / 0.000
0 / 25 (52.1) / 40 (87.0)
1 / 20 (41.7) / 6 (13.0)
More than 2 / 3 (6.2) / 0 (0)
MOAA/S score
At the initiation of thebronchoscopy
procedure: 5 (alert)/4/3/2/1/0 (asleep) / 0/0/11/37/0/0 / 0/0/0/0/0/46 / 0.000
5 min after thebronchoscopy procedure: 5 (alert)/4/3/2/1/0 (asleep) / 2/38/6/2/0/0 / 0/0/0/0/0/46 / 0.000

WNJ group,propofol-lidocaine-remifentanil with supraglottic pulsatile jet oxygen and ventilation (SJOV)group;

NCO group: remifentanil with nasal cannula supplement oxygen

Table 4 Adverse events during the flexible bronchoscope

Adverse event / NCO group (n=48) / WNJ group(n=46) / P-value
Hypertension / 20 (41.7) / 0 (0) / 0.000
Hypotension / 1 (2.1) / 4 (8.7) / 0.153
Tachycardia / 23 (47.9) / 0 (0) / 0.000
Bradycardia / 0 (0) / 1 (2.2) / 0.304
Arrhythmia / 7 (14.6) / 1 (2.2) / 0.031
Pneumothorax / 0 (0) / 0 (0) / --
Subcutaneous emphysema / 0 (0) / 0 (0) / --
Sore throat / 12(25.0) / 10(21.7) / 0.709
Coughing / 30(62.5) / 3 (6.5) / 0.000
Nose bleeding / 15(31.2) / 16(34.8) / 0.716
Bronchospasm / 0 (0) / 0 (0) / --

WNJgroup,propofol-lidocaine-remifentanil with supraglottic pulsatile jet oxygen and ventilation (SJOV)group;

NCO group: remifentanil with nasal cannula supplement oxygen

Figure 1 CONSORT flow diagram. Ninety-sixpatients were randomized; two patients asked to quit the study in the WNJ group. WNJ group,propofol-lidocaine-remifentanil with supraglottic pulsatile jet oxygen and ventilation (SJOV)group; NCO group: remifentanil with nasal cannula supplement oxygen.

AB

C

Fig 4Respiratory functions during flexible bronchoscopy. The changes of rate (RR, A),end-tidal CO2 (PetCO2, B)and oxygen saturation (SpO2, C) were illustrated separately. Data are shown as Mean±standard deviation. T0, baseline; T1, passage of the bronchoscope through vocal cords; T2, 1 min after T1; T3, 5 min after T1; T4, the end of bronchoscopy.WNJ group,propofol-remifentanil-lidocaine with supraglottic pulsatile jet oxygen group; NCO group: remifentanil with nasal cannula supplement oxygen.﹡P<0.05 vs. The NCO group, ＃P<0.05 vs. the T0 time point.

AB

Figure 5. Hemodynamics during flexible bronchoscopy. Changes in heart rate (HR, A) and mean arterial pressure (MAP, B) were demonstrated. Data are shown as Mean±standard deviation. T0, baseline; T1, passage of the bronchoscope through vocal cords; T2, 1 min after T1; T3, 5 min after T1; T4, the end of bronchoscopy. WNJ group,propofol-remifentanil-lidocaine with supraglottic pulsatile jet oxygen group; NCO group: remifentanil with nasal cannula supplement oxygen.﹡P<0.05 vs. The NCO group, ＃P<0.05 vs. the T0 time point.

AB

Figure 6.Facilitation of flexible bronchoscope. Satisfaction scores of patients and bronchoscopists (A) and cough score (B) are demonstrated. Data are shown as Mean±standard deviation. WNJ group,propofol-remifentanil-lidocaine with supraglottic pulsatile jet oxygen group; NCO group: remifentanil with nasal cannula supplement oxygen.﹡P<0.05 vs. The NCO group.