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 termsof 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 followingthe ethics committee approval. The patients were randomized into two groups (n=35), and standard routine monitoring were appliedto them. The sedation depth was evaluated with Ramsey Sedation Score (RSS) before and after the sedation; and cognitive functionsof 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 thegroups, 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 comparedto the preoperative period (p<0.05). The hemodynamic parameters were lower in Group DR than in Group PR at 5th, 10th and 15thminutes 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 betterpostoperative cognitive function, recovery conditions, analgesia, and patient and surgeon satisfaction compared to the Propofol-Remifentanil combination.