Introduction: Propofol contributes largely in the rapid evolution of day care surgery due to its superior recovery characteristics. However, it is associated with dose-dependent systemic arterial hypotension which increases morbidity and mortality. Bispectral index or BIS is an Electroencephalographic (EEG) derived parameter used to assess the depth of anaesthesia. Titrating drugs to a specific BIS value during general anaesthesia allows to adjust the dose of anaesthetic needed by the patient thereby, reducing the dose related side-effects. Aim: To determine whether the dose of propofol guided BIS values causes less arterial hypotension than the commonly used sleep dose method. Materials and Methods: The present study was a randomised control trail conducted on 92 patients of American Society of Anesthesiologists (ASA) I and II physical status, aged 18-60 years, of both genders, scheduled for elective surgeries under general anaesthesia and were randomly divided into group A and B (46 in each). For induction of anaesthesia, Group A received propofol till the BIS values reached 50±1 for 30 seconds, while Group B received sleep dose of propofol without BIS monitoring. Haemodynamic effects Heart Rate (HR), Diastolic Blood Pressure (DBP), Systolic Blood Pressure (SBP) and Mean Arterial Pressure (MAP) were recorded at baseline, during induction and at 1, 5, 10 and 15 minutes after intubation. Total propofol consumption and secondarily, level of sedation after extubation using Ramsay Sedation Scale were also measured in both the groups. Results: The total dose requirement of propofol was reduced significantly in group A compared to group B (p<0.005). Blood pressure decreased from the baseline in both the groups following induction with propofol but was insignificant. HR increased by 2.2% in group A while it decreased by 8.5% in group B but was insignificant (p>0.005). On arrival to Post Anesthesia Care Unit (PACU), group A were more co-operative, oriented patients compared to group B (67.4% vs 32.6% respectively). Conclusion: BIS monitoring significantly reduces the consumption of propofol for induction of anaesthesia while the incidence of hypotension was similar in both the groups. Lower sedation level with comparatively better extubation score with the use of BIS helps in fast tracking.

Introduction: General anaesthesia with endotracheal intubation, being one of the most commonly performed procedures in clinical anaesthesiology, is not without adverse effects. Postoperative Sore Throat (POST) is one of the common adverse effects with a varying incidence. Prophylactic management of POST is recommended to improve the quality of postanaesthesia care and recovery. Aim: To evaluate the effectiveness of preoperative nebulisation with magnesium sulphate and budesonide in reducing the incidence and severity of POST. Materials and Methods: This randomised double-blinded control study was conducted in the Department of Anaesthesiology at Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India, from September 2021 to December 2021. The study included 120 patients, of either sex, aged between 20-60 years with American Society of Anesthesiologists (ASA) grade I and II posted for elective surgery requiring general anaesthesia with endotracheal intubation. The patients were randomly divided into three groups of 40 patients each. Group M was nebulised with 250 mg magnesium sulphate, Group B with 250 mcg budesonide and Group S was nebulised with normal saline, 15 minutes prior to the induction of anaesthesia. Incidence and severity of POST was documented at 0 hr, 2 hrs, 24 hrs and 48 hrs postextubation on a 0-3 score. Data collected was analysed using Statistical Package for Social Sciences (SPSS) version 22.0 and the results were then statistically analysed using Analysis of Variance (ANOVA) and Chi-square test. Results: The incidence of POST was more in saline group when compared with budesonide and magnesium sulphate group at all points of observation (0 hr, 2 hrs, 24 hrs and 48 hrs). The severity of POST was moderate in saline group while the other two groups experienced mild severity. This was statistically significant at 0 hr, 2 hrs and 24 hrs (p-value <0.05). But at 48 hrs severity of POST among the three groups was not significant. Conclusion: Preoperative nebulisation with magnesium sulphate and budesonide significantly reduces the incidence and severity of postoperative sore throat.