Abstract
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/ .