Comparison of oxygen delivery methods for patient undergoing monitored anesthesia care in endoscopic procedures.

Patient will undergo pre-anesthesia workup ,written and informed consent will be taken. All patient will be kept nil by mouth 8 hrs for solid 2 hrs for clear liquid, patient with concurrent illness take medication.Preprocedural preaparation by lidocaine oral topical solution, topical pharyngeal spray with 10% lidocaine spray for upper endoscopy. Patient randomly allocated into two group using winpipe software a) nasal prongs b) t piece via nasopharyngeal airway with FiO2 between 40-60%. Patients vitals(Spo2, heart rate,respiratory rate,blood pressure) are monitored on table, every 5 mins till the end of procedure. Adverse events and correction done such as hypoxia- head tilt, chin lift,securing airway by nasopharyngeal airway, increase flow of O2 or intermittent O2 flush, bag and mask ventilation, bradycardia- fluid and vasopressor, body movement - additional dose of anesthetic drug, bleeding from nose - local pressure application, Aspiration- oral nasal suctioning interruption of procedure and securing definite airway , Ramsay sedation score will be maintained >4 during endoscopy. We focus on comparing two different methods of oxygen delivery in flexible endoscopic procedure and thereby finding out the best method of oxygen delivery for safe and efficient monitored anesthesia care for patients undergoing flexible endoscopic procedure.