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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionApplication for ESRA Abstract PrizesBackground and AimsNasal intubation technique was first described in 1902 by Kuhn. Nasotracheal intubation(NTI) has a high rate of nasal trauma. Various methods like prewarming the tube, using red rubber catheter to railroad tube were used to reduce trauma. Gum elastic bougie (GEB) is one such technique, when used as a conduit has shown to reduce post intubation nasopharyngeal trauma.MethodsA Prospective interventional randomized control trial was conducted from 31/10/2018 to 31/05/2021 at a tertiary health care hospital in New Delhi. After obtaining Ethical clearance from the institutional committee, patients were randomly allocated by closed envelope technique into two groups, group B and group NB with 45 participants each. In group B, Gum elastic bougie was used to guide the endotracheal tube while in group NB, no such adjunct was used. The main aim of the study was to compare the incidence and severity of nasopharyngeal bleeding adult patients undergoing elective surgery. The other parameters observed were time taken for intubation and ease of intubation.ResultsThe grade of bleeding at 1 min and 5 min after intubation was significantly lower in the group B as compared to group NB. The time taken for intubation was significantly lower in the group B. The ease of intubation was comparable in both the groups.ConclusionsThe study concluded that Videolaryngoscopic assisted bougie guided NTI with a GEB in adult patients reduces the incidence and severity of nasopharyngeal trauma after intubation. It does not increase the time taken for nasotracheal intubation.

Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionApplication for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)Background and AimsPreoxygenation is an important procedure which is necessary prior to induction of General Anesthesia (GA). It is achieved by administering oxygen using devices like face mask, nasal prongs etc and is characterised by increasing safe apnoea time. .By increasing safe apnoea time , we can prevent possible life threatening events which can occur during ventilation or intubation, during securing airway. Aim of Study: To evaluate and compare role of preoxygenation with HFNC vs preoxygenation with facemask in improving oxygenation and decreasing episodes of desaturation during induction in cervical cord injury patients.MethodsWe designed a prospective observational study and got it approved from institutional ethical committee ((IEC:2022–104-IMP-128, PGI/BE/512/2022). .For both the groups baseline ABGA (T0), ABG after preoxygenation ABGA (T1) and ABG after confirming intubation ABG (T2) was done.PaO2 trajectory through the procedure including apnea time was recorded. Statistical testing was performed for Patient data and ABG results using Wilcoxon test, Man-Whitney-U test and Chi-square test and Statistical significance level was assumed for p value lower than 0.05.ResultsThe basal characteristics showed no difference between the two groups. The mean apnoea times showed no significant difference between the two groups, 156.4±44.0 seconds and 151.2±61.3 seconds, in mask and HFNC groups, respectively (P=0.732). The longest safe apnea time was 412 seconds in the HFNC group. PaO2 at T2, which was the primary outcome of this study, showed a statistically significant difference. PaO2 at T2 of the HFNC group was higher, 454.2 mm Hg (95% confidence interval [CI], 414.1–489.52 mm Hg), while that of the mask group was 369.6 mm Hg (95% CI, 329.7–404.5 mm Hg) (P=0.002).ConclusionsIn this prospective randomized controlled study, preoxygenation using the HFNC showed higher PaO2 immediately after intubation compared to the conventional method with a simple face mask.

Visual laryngoscope, as the most commonly used tracheal intubation tool in clinical practice, has a high intubation success rate and is quick to learn, but there are risks of over flexion of the neck, tooth loss, etc. The visual stylet helps to make up for these shortcomings. This study aimed to compare the effects of the visual stylet and visual laryngoscope on transoral single lumen tracheal intubation in non-difficult airways. The primary outcome was intubation time, and secondary outcomes included glottic exposure time, first success rates, hemodynamic indices, intubation-related complications. A total of 148 patients were included, with 75 in the visual stylet (VS) group and 73 in the visual laryngoscope (VL) group. The intubation time in the VS group was 35 (11) seconds, significantly shorter than the 41 (9) seconds in the VL group ( P  < 0.001). Immediately post-intubation, the MAP in the VS group was 80 (20.5) mmHg, lower than 87 (23) mmHg in the VL group ( P  < 0.01). Intubation-related complications are also lower in VS group compared to VL group. Other outcomes don’t have significant difference. Our study has demonstrated that the visual stylet significantly reduces intubation time and provides more stable hemodynamics. For patients with limited mouth opening, shorter thyromental distance, or higher Cormack-Lehane grades, the visual stylet may potentially be a better choice compared to video laryngoscopy for tracheal intubation. Trial registration China Clinical Trial Registry (ChiCTR2100051812) (05/10/2021).

Intubation in neonates is challenging, and repeated attempts are associated with adverse events. Among neonates undergoing urgent intubation, video laryngoscopy resulted in more successful first attempts than direct laryngoscopy.

Adequate bowel preparation facilitates ileocolonoscopy completion. Pediatric Endoscopy Quality Improvement Network (PEnQuIN) quality standards recommend unadjusted rates of adequate bowel preparation of ≥ 80% and terminal ileal intubation ≥85%. A Boston Bowel Preparation Scale (BBPS) score of ≥6 is adequate. This study aims to identify whether UK hospitals are attaining PEnQuIN standards, and reviews medications used.Fifteen UK hospitals participated. Local governance processes were followed. Each hospital provided anonymous BBPS data. Patients were grouped according to bowel preparation drug type. Patients were excluded if procedures were abandoned due to significant bleeding, stricture, previous resections or severe disease and if a subgroup had below 5 patients. A single factor Anova test and two sample T-Test was performed.Complete data for 209 patients from 12 hospitals was collated. Five of 12 participating hospitals attained the PEnQuIN standard for adequate bowel preparation. Bowel preparation drugs varied greatly among hospitals. Patients were grouped according to drug type for analysis(see table 1).Abstract OC68 Table 1GroupDrug/sN° PatientsPercentage achieving BBPS score of ≥6Ileal IntubationAPicosulphate & Senna10265.7%97.1%BPicosulphate6979.7%95.7%CCitramag2592%88%Only Group C achieved the desired adequate bowel preparation rate of ≥ 80%. Not all groups are equal (p<0.006) on single factor Anova analysis. Significant differences in BBPS scores between groups A&C and B&C were found on a paired T test. Significant subgroup variability exists regarding drug timing, dosage and frequency resulting in heterogeneity.This initial study highlighted marked variability in the UK use of bowel preparation medications. Only Group C attained the PEnQuIN standard for adequate bowel preparation. Groups A and B achieved high ileal intubation rates despite not meeting the standard. A large prospective multi-centred trial is required to establish the ideal medication type and protocol for bowel preparation in children.

The purpose of this study was to evaluate whether 'Priming Principle' applied to the induction dose of propofol would affect the total induction dose requirements and its attendant heamodynamic instability. Conclusion: The result of this study revealed that applying the priming principle is effective in reducing the induction dose requirement of propofol with minimal post-induction haemodynamic changes.

Hypoxemia during tracheal intubation may increase the risk of cardiac arrest and death. In this multicenter trial, adults undergoing tracheal intubation were randomly assigned to receive bag-mask ventilation during the interval between induction and laryngoscopy or no ventilation. Bag-mask ventilation increased oxygen saturation as compared with no ventilation.