RESUMO
Background: Propofol combined with alfentanil is suitable for intravenous anesthesia for day-case hysteroscopy. Objective: To investigate the median effective dose (ED50) and 95% effective dose (ED95) of alfentanil compounded with propofol for day-case hysteroscopy. Design: In all, 29 patients who volunteered for painless hysteroscopy in 2022 were recruited. 1.5 mg/kg propofol was given as a sedative to all patients. The trial was conducted using the modified Dixon sequential method, with an initial dose of 10 µg/kg of alfentanil, and the subject's alfentanil dose depended on whether the prior hysteroscopy had failed, which was defined as inadequate cervical dilatation and hysteroscope placement with the patient exhibiting body movement, frowning, or a MOAA/S score >1. If the hysteroscopy failed (i.e. a positive response), the subsequent subject's alfentanil dosage was raised, and conversely (i.e. a negative response), the dose was decreased, with the adjacent dose ratio always being 1:1.2. The formal test begins with the first crossover wave and lasts until seven crossover waves materialize. Methods: The probit method was used to calculate the ED50, ED95, and corresponding 95% confidence intervals (CIs) of alfentanil compounded with propofol for hysteroscopy. Results: The ED50 and ED95 of alfentanil combined with propofol for day-case hysteroscopy were 5.701 (95% CI: 3.841-7.069) µg/kg and 8.817 (95% CI: 7.307-20.868) µg/kg, respectively. Conclusion: Alfentanil at 8.817 µg/kg in conjunction with propofol is a successful and safe approach for day-case painless hysteroscopy. Trial registration: The trial registry name: Modified sequential method to determine the half-effective dose of alfentanil compounded with propofol for ambulatory hysteroscopy. The URL of registration is https://www.chictr.org.cn/showproj.html?proj=171786, where the full trial protocol can be accessed. Registration number: ChiCTR2200061619.
Alfentanil combined with propofol is suitable for day-case hysteroscopy Why was this study done? Hysteroscopy is a procedure in which a hysteroscope is placed after the cervix is dilated to observe lesions in the uterine cavity. This study explores the effective dose of alfentanil combined with propofol for day-case (i.e., patients admitted and discharged on the same day) hysteroscopy to provide patients with comforting anesthesia (i.e., pain relief) during hysteroscopy. What did the researchers do? The research team recruited 29 patients who volunteered for painless hysteroscopy in 2022. All patients received alfentanil and propofol for intravenous anesthesia. If anesthesia was not effective, subsequent subjects increased the dose of anesthetic medication, and vice versa, the dose was decreased. According to this method, we can find the optimal dose of anesthetic drugs in hysteroscopy. What did the researchers find? The effective dose of alfentanil combined with propofol in patients undergoing painless hysteroscopy was 8.817 µg/kg. What do the findings mean? Alfentanil at 8.817 µg/kg in conjunction with propofol is a successful and safe approach for day-case painless hysteroscopy.
