Background: Gastrointestinal Endoscopy under Total Intravenous Anesthesia (GETIVA) is used for gastroin-testinal disease investigation. Total intravenous anesthesia with propofol and opioids is usually applied but could result in respiratory depression or low oxygen saturation. This study aimed to test the effectiveness of nikethamide (respiratory stimulant) for alleviating low oxygen saturation induced by combined propofol and sufentanil use during GETIVA.

Methods: This randomized controlled trial was performed in an in one center in Wuxi City, China, in total, 135 patients scheduled to undergo painless gastrointestinal endoscopy were enrolled and divided into nikethamide and saline groups. Nikethamide was intravenously injected following sufentanil and propofol intravenous administration in the nikethamide group; an equivalent volume of normal saline was injected in the saline group. The primary outcomes were the incidence of low oxygen saturation, oxygen flow increase, lower jaw lifting, oxygen inhalation (with facemask), and assisted ventilation.

Results: The incidences of increased oxygen flow, lower jaw lifting, and oxygen inhalation (with mask) were lower in the nikethamide group versus the saline group (P<0.05). No significant differences in the mean arte-rial pressure, heart rate, or oxygen saturation were observed at any point between the groups. The sufentanil dose, endoscopy time, post-anesthesia care unit awaking time, and satisfaction of the patients and endoscopy physicians were not significantly different. The propofol dose was higher in the nikethamide group than in the saline group (P<0.05).

Conclusions: Nikethamide could decrease respiratory depression during GETIVA performed with combined propofol and sufentanil use; however, it increased the required propofol dose