Effects of a repeated verbal reminder of breathing pattern on emergence agitation after general anaesthesia for nose and sinus surgeries A one year randomised controlled trial

Emergence agitation is a well known early postoperative negative behavior having many complications .It occurs more frequently in nasal and sinus surgeries due to higher sense of suffocation due to nasal packing .This randomised controlled trial is designed to examine the impact of verbally reminding the patients of their breathing pattern on occurrence of emergence agitation following general anaesthesia in contrast to patients who simply heard their own names during extubation.

Patients will be assigned into two groups .In Interventional group the subject will be given information on course of general anaesthesia and instruction regarding breathing pattern will be provided during pre anaesthesia evaluation.

Then after subject enters the operating room before the induction of anaesthesia the subject will again be reminded and instruction of breathing pattern will be provided .

After the surgery at the start of emergence procedure they will be provided with repeated reminder of breathing pattern through headphones on patient ears with message playing on loop that Breathe through your mouth as your Nostril is packed you are now recovering from general anaesthesia after surgery open your eyes We are about to take out the tube Breathe calmly

No tactile stimulation will be allowed during the emergence .The Riker sedation agitation scale SAS will be used to score

The primary outcome will be the incidence of emergence agitation  which is defined as maximal SAS score more than equal to 5 .Secondary outcome will be Data on incidence of Dangerous emergence agitation SAS equal to 7 and Maximal SAS score during emergence and Vitals at 0 min 5 min and 10 min after extubation

Whereas those in the control group will not receive any instruction of breathing pattern previously and during extubation .They will verbally hear only their own name during extubation.