{
  "abstract": "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 Aims Laryngoscopy and endotracheal intubation can trigger a pronounced sympathetic response, traditionally managed with opioid administration. Lately, opioid-free anesthesia has been implemented as an alternative strategy to minimize opioid-related side effects. The aim of this study was to assess the nociceptive response as measured by the Nociception Level (NOL) index, during laryngoscopy and intubation in patients subjected to opioid-free versus opioid-based inductionMethods This prospective, randomized, double-blind, controlled study included 70 patients (ASA I–II, both sexes) undergoing elective surgery under general anesthesia. Patients were allocated to two groups based on the agents administered prior to propofol induction: the OFI (opioid-free induction) group received a combination of dexmedetomidine, ketamine, and lidocaine, while the OBI (opioid-based induction) group received fentanyl. Nociceptive responses were evaluated using the NOL index during a 5-minute period post laryngoscopy and intubationResults Data were analyzed using four different metrics throughout the 5-minute post-intubation period to compare nociceptive responses between the two groups. These were the medians of all NOL values, the sum of all NOL values above the 25 threshold, the medians of all NOL values above 25 and the means of the highest 30 seconds of NOL values within the period of interest. All metrics revealed a statistically significant difference, indicating that nociceptive responses to laryngoscopy and intubation is milder in the OFI group compared to OBI group (p=0.027, 0.022, 0.00052 and 0.005, respectively)Conclusions This study highlights that opioid-free induction was associated with a significantly attenuated nociceptive response to laryngoscopy and intubation, as measured by the NOL index.",
  "authors": [
    {
      "affiliations": [
        "Department of Anesthesiology and Pain Medicine, Aretaieion University Hospital, National and Kapodistrian University of Athens, Greece, Athens, Greece"
      ],
      "name": "Christina Orfanou"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Pain Medicine, Aretaieion University Hospital, National and Kapodistrian University of Athens, Greece, Athens, Greece"
      ],
      "name": "Marianna Mavromati"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Pain Medicine, Aretaieion University Hospital, National and Kapodistrian University of Athens, Greece, Athens, Greece"
      ],
      "name": "Kassiani Theodoraki"
    }
  ],
  "title": "P288 The NOL knows: tracking nociception during induction, laryngoscopy and intubation. A randomized double-blind study",
  "uid": "676eb29f-ceb5-5d05-bb0a-ccfced433181"
}