COMPARISON OF PROPOFOL-REMIFENTANYL AND PROPOFOL-DEXMEDETOMIDINE USE IN OUTPATIENT ENDOMETRIAL BIOPSIES AND/OR CURETTAGES

Aslan Bilge (M.D)*, Güner Beyhan (M.D), Aktürk Hilal (M.D), Abdullah Atar (Assistant Technician)

ABSTRACT

Introduction: Using single anesthetic agent in endometrial biopsy sampling and/or probe curettage (EBS and/or PC) may lead to inadequate analgesia and sedation. To achieve the adequate analgesia and sedation the single anesthetic agent doses must be increased which causes unwanted side effects. For avoiding high doses of single anesthetic agent nowadays combination with sedative agents is mostly a choice for analgesia and sedation for EBS and/or PC. Aim: The aim of this study is to investigate the effects of propofol + remifentanil, and propofol + dexmedetomidine combinations on the total dose of propofol to be administered during EBS and/or PC and on the pain scores after the process. Materials and Method. This randomized study was performed with 108 patients (ASA I-II-III) ranging between 18 and 70 years of age who underwent sedation/analgesia for elective . The patients were administered remifentanil (1 μg/kg) + propofol (1,5 mg/kg) in Group Ι, dexmedetomidine (1 μg/kg) + propofol (1,5 mg/kg) combination in Group II. All the patients‟ sedation levels were assessed with the Ramsey Sedation Scale (RSS). Their recovery was assessed with the Aldrete and Numerical Rating Scale Score (NRS) at 10 min intervals. Results. The total doses of propofol administered to the patients in the two groups in this study were as follows: 150 mg in Group I, and 245 mg in Group II. Conclusion: Propofol-dexmedetomidine combination is as effective as propofol-remifentanil combination but with fewer side effects for conscious sedation during EBS and/or PC sugery. It was observed that, in the patients undergoing EBS and/or PC, administration of propofol in combination with an opioid or α2 receptor agonist provided effective and reliable sedation, reduced the total dose of propofol, increased the practitioner satisfaction, decreased the pain level, and provided hemodynamic stability . Sedation Score, patients‟ satisfaction, surgeons‟ satisfaction, heart rate, mean arterial blood pressure, and oxygen saturation were recorded. Side effects such as respiratory depression, nausea, vomiting, airway obstruction, and oxygen desaturation were also recorded.

Keywords: Probe curtaj - Conscious sedation - Narcotics - Adrenergic alpha2 receptor agonists.