DOI: https://doi.org/10.36347/sasjs.2026.v12i04.002

Pages: 261-266

Background: Peri-intubation hypoxemia remains a frequent and potentially life-threatening complication of airway management, particularly in resource-limited settings. Apneic oxygenation has been proposed as a simple, low-cost strategy to extend safe apnea time during tracheal intubation. Materials and Methods: We conducted a prospective, controlled, before-after study in the operating theatre of Essos Hospital Center (Yaoundé, Cameroon) over a 4-month period. Adult patients undergoing elective or emergency tracheal intubation were enrolled. During the control phase, patients received standard preoxygenation alone. During the intervention phase, apneic oxygenation was systematically administered via nasal cannula at a flow rate of 10 L per minute during laryngoscopy. The primary outcome was the incidence of oxygen desaturation below 90%. Secondary outcomes included the lowest oxygen saturation during intubation, time to desaturation, and first-pass intubation success. Results: A total of 160 patients were included, with 80 patients in each phase. The incidence of desaturation below 90% was significantly lower in the intervention group than in the control group (9% vs. 28%; P<0.001). The median lowest oxygen saturation increased from 91% (interquartile range, 88 to 95) to 96% (interquartile range, 94 to 98) (P<0.001). The median safe apnea time increased from 65 to 110 seconds (P<0.001). First-pass success was higher in the intervention group, although the difference did not reach statistical significance (90% vs. 82%; P=0.12). Conclusion: Apneic oxygenation significantly reduces the risk of peri-intubation hypoxemia and prolongs safe apnea time. This simple and cost-effective intervention may represent a valuable strategy for improving airway safety, particularly in resource-limited settings.