Dexmedetomidine-dezocine versus propofol-remifentanil anesthesia for ultrasound-guided transvaginal oocyte retrieval: a randomized controlled trial.

BACKGROUND AND

OBJECTIVES

Transvaginal ultrasound-guided oocyte retrieval, a core component of in vitro fertilization-embryo transfer (IVF-ET) techniques, is an outpatient procedure that requires rapid awakening while ensuring adequate analgesia. The currently widely used regimen of propofol-remifentanil presents limitations. The aim of this study was to evaluate the clinical efficacy and safety of dexmedetomidine-dezocine in transvaginal ultrasound-guided oocyte retrieval.

METHODS

A single-center prospective randomized controlled trial included 124 patients randomly divided into Group D (dexmedetomidine-dezocine, n = 62), and Group P (propofol-remifentanil, n = 62). The primary outcome measure was time to complete wakefulness (time from drug withdrawal to OAA/S score ≥ 4). Secondary outcome measures included intraoperative body movement scale, Ramsay sedation scale, hemodynamic parameters, and adverse reactions.

RESULTS

There were no statistical differences between the two groups in intraoperative limb movement grading (p = 0.12), operator satisfaction score (4.65 ± 0.78 vs. 4.55 ± 0.72, p = 0.3348), and patient satisfaction (7.39 vs. 7.10, p = 0.407). Group D had higher oxygen saturation than Group P (97.8% vs. 96.3%, p = 0.002) and a more stable respiratory rate (14.8 ± 2.3 vs. 13.0 ± 2.6, p < 0.001). Group D also had a shorter time to complete wakefulness than Group P (15.02 vs. 15.87 min, minutes, p = 0.019) and a higher Observer's Assessment of Alertness/Sedation (OAA/S) score at the end of the procedure (2.06 vs. 1.64, p = 0.011). Mean arterial pressure and heart rate were not significantly different between the two groups (p = 0.88 and p = 0.93, respectively). The incidence of major adverse events was similar between groups. However, this study did not assess embryo quality or pregnancy outcomes, which represents a limitation.

CONCLUSIONS

This exploratory study suggests that dexmedetomidine-dezocine regimens may represent a potential anesthetic option for transvaginal oocyte retrieval. However, further research is needed to validate these findings.

TRIAL REGISTRATION: (TCTR20240601001) [Registered on: 01/06/2024]. This trial is registered with the Thailand Clinical Trials Registry https://www.thaiclinicaltrials.org/ .