Influence of dexmedetomidine nebulisation on isoflurane requirement in patients undergoing entropy guided general anaesthesia- a double blinded randomised control trial.

Inhalational anaesthetic agents like Isoflurane are commonly used to maintain depth of anaesthesia but they are associated with adverse effects such as hemodynamic instability, respiratory depression and potential occupational hazards due to operating room pollution .Minimising the dose of these agents while maintaining adequate depth of anaesthesia is essential for optimizing patient safety

Dexmedetomidine is a potent centrally acting highly sedative alpha 2 receptor agonist with sympatholytic, amnestic, analgesic, anxiolytic properties .

Nebulised dexmedetomidine offers a non-invasive, patient friendly alternative for premedication, which may help attenuate the intraoperative stress response and reduce the requirement of inhaled agent

Entropy monitoring, derived from electroencephalographic signals, enables realtime titration of anaesthetic agents, ensuring precise control over anaesthetic depth. Integrating entropy guidance with dexmedetomidine nebulization may potentially lower isoflurane consumption, reduce sympathetic stimulation and minimize perioperative complications thereby improving the recovery profile of patients.Despite promising pharmacological profiles, there is limited literature on the combined use of nebulized dexmedetomidine and entropy guided anaesthesia.

This gap underscores the need for further investigation to validate its efficacy in reducing inhalational agent requirements, improving hemodynamic stability, and minimizing intraoperative hazards.Thus, this study aims to evaluate the efficacy of nebulized dexmedetomidine in reducing the requirement of inhalational anaesthetics using entropy-guided monitoring and recovery in terms of time required for eye opening and extubation.