Comparison of the effects of dexmedetomidineremifentanil and propofol-remifentanil combinations on postoperative cognitive functions in patients undergoing hysteroscopy: A randomized prospective study

Abstract

Aim: In the present study, we aimed to compare Dexmedetomidine-Remifentanil and Propofol-Remifentanil combinations in terms of postoperative cognitive functions in hysteroscopy attempts. Material and Methods: A total of 70 ASA I-II patients who were aged between 18 and 65 years were included in the study following the ethics committee approval. The patients were randomized into two groups (n=35), and standard routine monitoring were applied to them. The sedation depth was evaluated with Ramsey Sedation Score (RSS) before and after the sedation; and cognitive functions of the groups were evaluated with the Minimal Mental State Test (MMST). Propofol 1 mg/kg bolus 25-100 µg/kg/min infusion was administered to Group PR, and Dexmedetomidine 1 µg/kg bolus 0.4-0.7 µg/ kg/h infusion dose was administered to Group DR. Remifentanil 0.25 µg/kg bolus 0.04 µg /kg/min infusion was administered to the groups, and the groups were followed to ensure RSS≥4. Result: In cognitive functions, it was observed that there was significant regression in Group PR in postoperative period compared to the preoperative period (p<0.05). The hemodynamic parameters were lower in Group DR than in Group PR at 5th, 10th and 15th minutes following the hysteroscopy (p<0.05). The Modified Aldrete Score in Group DR were high, and pain scores were lower (p<0.05). Satisfaction with the surgeon, patient and anesthetist scores were higher in Group DR. No respiratory depression was observed (p<0.05). Conclusion: We believe that administering Dexmedetomidine-Remifentanil combination in sedation in hysteroscopy ensures better postoperative cognitive function, recovery conditions, analgesia, and patient and surgeon satisfaction compared to the PropofolRemifentanil combination.