Objective To explore the application effect of transnasal humidified rapid-insufflation ventilatory exchange(THRIVE) on patients with obesity undergoing painless gastroscopy. Methods A total of 80 obese patients requiring painless gastroscopy in Zhangzhou Zhengxing Hospital between January 2019 and January 2021 were selected as the research subjects, and they were divided into rapid-insufflation group (n=40) and traditional group (n=40) by drawing lots.THRIVE was used during intravenous anesthesia in rapid-insufflation group and traditional nasal cannula oxygen inhalation was adopted in traditional group.The gastroscopy status, vital signs, adverse events and occurrence of adverse reactions were compared between the two groups. Results There were no statistical differences in the recovery time of anesthesia and the dosage of Propofol between the two groups (P＞0.05), and the gastroscopy time in rapid-insufflation group was shorter than that in traditional group, and the difference was statistically significant (P＜0.05).There were no statistical differences in mean arterial pressure (MAP) and heart rate (HR) before anesthesia, at the beginning of examination and during 5 min of examination between the two groups (P＞0.05).The MAP and HR at the end of gastroscopy in rapid-insufflation group were lower than those in traditional group, and were lower than those at the beginning of examination, and the differences were statistically significant (P＜0.05).There was no statistical significance in blood oxygen saturation (SpO2) between the two groups before anesthesia (P＞0.05), and the SpO2 values in rapid-insufflation group at the beginning of gastroscopy, during 5 min of gastroscopy and at the end of gastroscopy were higher than those in traditional group, and the differences were statistically significant (P＜0.05).There was no significant difference in SpO2 at the beginning of examination compared with that during 5 min of examination in rapid-insufflation group (P＞0.05), but the difference was statistically significant at any two time points in rapid-insufflation group (P＜0.05).The total incidence rate of adverse events in rapid-insufflation group was lower than that in traditional group,and the difference was statistically significant (P＜0.05).There was no statistical significant differences in the total incidence rate of adverse reactions between the two groups (P＞0.05). Conclusion The application of THRIVE during intravenous anesthesia can shorten the exa mination time, maintain the stability of vital signs and reduce the occurrence of adverse events of patients with obesity undergoing painless gastroscopy, with safety.