Original title: Respiratory Support With Nasal High Flow Reduces Opioid Requirements During Endoscopic Retrograde Cholangiopancreatography
Tomotaka Mori, Takao Ayuse, Shuntaro Sato, Taiga Ichinomia +12 · September 2026
Doctors often use opioid pain medications during a specialized procedure called ERCP, which examines the digestive system. However, opioids can cause a patient to breathe too slowly and delay recovery. Researchers tested whether a breathing device called nasal high flow could help. Nasal high flow delivers warmed oxygen at a high speed. This improves oxygen levels, cuts down the physical effort of breathing, and keeps airflow steady. In the trial, doctors gave sedated patients either nasal high flow or standard low-flow oxygen. They found that patients using nasal high flow needed significantly less opioid medication. These patients also achieved deeper sedation, yet their breathing remained stable and their oxygen levels matched those who received standard treatment. No bad reactions occurred from either method. The team concluded that nasal high flow effectively supports breathing during procedures, which safely lowers how much opioid medicine a patient requires.
Imagine you are trying to fall asleep on a long car ride, but the driver keeps turning up the heat and cracking the window just enough to keep you awake. You ask for a blanket, but the driver worries the blanket will make you too warm and drowsy. In this paper, the blanket is the opioid painkiller, and the car's ventilation system is the breathing support. The researchers found that by using a stronger, more comfortable air flow (like a better car vent), they could keep the passenger comfortable without needing as much blanket.
During a procedure called ERCP, doctors often give opioids to keep patients comfortable, but opioids can slow or stop breathing. This study found that using a special high-flow nasal cannula instead of standard oxygen allowed doctors to use 38% less opioid, while keeping patients safe. That means fewer breathing complications and faster recovery for people undergoing this procedure.
This was a single-center, open-label study with early enrollment termination (94 of 118 planned patients) due to slow recruitment, which may limit generalizability and statistical power. The abstract does not specify blinding, so potential bias from unblinded clinicians cannot be ruled out. The authors explicitly note that further multi-center studies are needed to confirm these findings.
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Respiratory Support With Nasal High Flow Reduces Opioid Requirements During Endoscopic Retrograde Cholangiopancreatography — Tomotaka Mori, Takao Ayuse, Shuntaro Sato et al. — DEN open — doi:10.1002/deo2.70421
Abstract licence: CC BY
Explanation generated by Synthesis from the abstract — it is not the original paper.