Evidence map›Paper›PMID 42265608›Full record

SynthesisBMC anesthesiology2026

Efficacy and safety of nasal mask compared to nasal cannula during procedural sedation in gastroscopy: a systematic review, meta-analysis, and trial sequential analysis.

Mohamed Yaseen Alfeetouri, Munder Lateiresh, Ayham Qatza, Engy Elkoury, Nuran Arif Benfaid, Muhammed Elhadi

Abstract readMeta-AnalysisSystematic ReviewComparative Study
PubMed Publisher
In one paragraph

Synthesis in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mohamed Yaseen Alfeetouri *Faculty of Medicine, University of Benghazi, Benghazi, Libya.ORCID http://orcid.org/0009-0004-5863-3932
Munder Lateiresh *Faculty of Medicine Foča, University of East Sarajevo, Foča, Bosnia and Herzegovina.ORCID http://orcid.org/0009-0002-4082-1949
Ayham QatzaFaculty of Medicine, Hama University, Hama, Syria.ORCID http://orcid.org/0009-0001-0424-2037
Engy ElkouryFaculty of Medicine, Tanta University, Tanta, Egypt.ORCID http://orcid.org/0009-0002-9666-5623
Nuran Arif BenfaidFaculty of Medicine, University of Tripoli, Tripoli, Libya.ORCID http://orcid.org/0009-0006-1437-6545
Muhammed ElhadiFaculty of Medicine, University of Tripoli, Tripoli, Libya. muhammed-elhadi@korea.ac.kr.ORCID http://orcid.org/0000-0001-6406-4212

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypoxemia is the most common adverse event during propofol-based procedural sedation for gastroscopy. Conventional nasal cannula oxygenation provides low flow rates, permitting room air entrainment and often proving insufficient. Nasal mask oxygenation delivers higher inspired oxygen concentrations, potentially enhancing respiratory safety during sedation.

objectiveThis study compared the efficacy and safety of nasal mask versus nasal cannula oxygen delivery during propofol-based procedural sedation for gastroscopy.

methodsElectronic databases/registries were systematically searched from inception to January 24, 2026, for randomized controlled trials (RCTs). Inclusion criteria encompassed adult patients undergoing propofol-based sedation for gastroscopy. The primary outcome was the incidence of hypoxemia. Secondary outcomes included severe hypoxemia, minimum oxygen saturation (SpO₂), need for airway or oxygenation interventions, procedure-related adverse events, and postoperative nausea and vomiting (PONV). Random-effects meta-analyses were performed using risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs). Trial sequential analysis (TSA) assessed the sufficiency of the evidence. Risk of bias was evaluated using RoB 2, and certainty of evidence using GRADE.

resultsFive RCTs enrolled 1,267 patients, of whom 1,252 (98.8%) were included in the quantitative synthesis. Nasal mask oxygenation significantly reduced hypoxemia (RR 0.40, 95% CI 0.28 to 0.58, p < 0.0001) and severe hypoxemia (RR 0.39, 95% CI 0.22 to 0.67, p = 0.0007) compared with nasal cannula. Nasal masks also decreased the need for jaw thrust (RR 0.40, 95% CI 0.31 to 0.52) and mask-assisted ventilation (RR 0.16, 95% CI 0.05 to 0.46), while elevating minimum SpO₂ (MD 3.78, 95% CI 1.39 to 6.16). No significant differences emerged in coughing, hiccups, or PONV.

conclusionsNasal mask oxygenation is associated with greater respiratory safety compared with nasal cannula oxygenation during propofol-sedated gastroscopy. This advantage manifests as reduced incidence of hypoxemia and fewer airway-related interventions, alongside a comparable overall safety profile. PROSPERO: CRD420261291468.

Indexed as

CannulaGastroscopyMasksOxygen Inhalation TherapyProcedural SedationHumansHypnotics and SedativesHypoxiaPropofolRandomized Controlled Trials as TopicHypnotics and SedativesPropofolAnesthesiaGastroscopyHypoxemiaMeta-analysisNasal cannulaNasal maskPropofolRandomized controlled trials

Identifiers

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.