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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 Dreaming under general anaesthesia has incidence rates ranging from 17.5% to 57% depending on timing of assessment and anaesthetic agents used. Previous studies suggest that dreams are typically pleasant and occur during lighter stages of anaesthesia, particularly near emergence. However, the relationship between the type of anaesthesia and dream incidence remains underexplored. Hypothesis: Patients receiving combined general anaesthesia (multimodal GA+regional/local anaesthesia) are more likely to experience and recall pleasant dreams compared to those MMGA without RA.Methods In this retrospective analysis, 44 patients undergoing surgery under regional or general anaesthesia were assessed postoperatively for the occurrence of dreams. Dream presence, age, opioid use, and anaesthetic technique were recorded. Patients were stratified based on dream recall (dream vs. no dream), and group differences were evaluated using descriptive statistics and chi-squared tests.Results Dreams were reported by 23/44 patients (52%). The median age of dreamers was 54 years (IQR 40–68), compared to 62 years (IQR 39–69.5) in non-dreamers. Most patients (31/44, 70%) received combined anaesthesia (multimodal GA+regional/local anaesthesia). A statistically significant association was found between regional anaesthesia use and dreaming (p = 0.025), suggesting that EEG-guided, opioid-sparing multimodal GA with RA facilitates dreaming. No significant association was observed between opioid use and dreaming (p = 1.0). Dream reporting patients were younger (median 54y (IQR 40–68)) than non-dream reporting (median 62y(IQR 39–69.5))Abstract P266 Figure 1Surgery matched (perforating keratoplastic) EEG in a 55 y old male non-dreamer (left) and 22 y old dreaming patient, both ASA 2; EEG-montage 4-electrode frontocentral (FP8; Fz, Pz); ‘Young dreamer’-EEG shows strong frontal and central alpha (8–12 Hz) and sigma (12–15 Hz); central ‘fast’ spindles have previously been correlated with dream recall in NREM sleepAbstract P266 Figure 2Middle aged patients were most likely to report dreams even after correcting for their weight in the sample. Of the women, 58% reported dreams, among men, 52% id as wellConclusions Dreaming under anaesthesia was common and associated with regional anaesthesia but not opioid administration in MMGA. These findings support the hypothesis that MMGA plus RA increases dream incidence and recall.