To verify the effect of sequential HFNC after extubation of tracheal intubation on postoperative hypoxemia and re-intubation rate in elderly patients after cholecystectom under general anesthesia.

In a prospective randomized controlled trial, 90 patients who underwent cholecystectomy under general anesthesia in the Department of Critical Care of the Third People's Hospital of Xinjiang Uygur Autonomous Region from January to December 2019 were randomly divided into HFNC group (n=30), nasal catheterization group (n=30) and mask group (n=30). Blood pressure, HR, and blood gas analysis indicators (PaO₂, PaCO₂, oxygenation index) before and after extubation were compared, as well as patient comfort level and reintubation rate after extubation.

Before tracheal extubation, there were no differences in HR, SBP, PaO₂, PaCO₂, and oxygenation index between the three groups (P＞0.05). One hour after extubation, there was no difference in HR and SBP among the three groups (P＞0.05). PaO₂ (P=0.013) and oxygenation index (P=0.009) in HFNC group were higher than those in mask group, PaCO₂ in HFNC group was lower than that in mask group (P=0.031), but there was no difference between HFNC group and nasal catheterization group (P=0.106, P=0.101, P=0.545). The complaints of mucous membrane dryness was the highest in the nasal catheterization group while claustrophobia, nausea and vomiting were the highest in the mask group (P＜0.05). Compared with the re-intubation rate, there was no difference between three groups (P=0.484).

For elderly patients with hypoxemia after cholecystectomy under general anesthesia, sequential HFNC after tracheal extubation can better improve PaO₂, PaCO₂, oxygenation index, and discomfort, but cannot reduce the rate of re-intubation.