The emergence profile of propofol sedation compared with dexmedetomidine injection during ultrasound-guided oocyte pickup for in-vitro fertilization

Background The purpose of this study was to assess the quality, the recovery, and side effects of propofol sedation compared with dexmedetomidine in a very short minimally invasive procedure such as ultrasound-guided oocyte pickup for in-vitro fertilization. Patients and methods Sixty-two female patients undergoing ‘ultrasound-guided oocyte pickup’ were randomly enrolled in the study, conducted in a specialized center (Elite Fertility Center, Cairo, Egypt). The emergence profile of sedation with propofol+fentanyl versus dexmedetomidine +fentanyl was compared. The sedation level was assessed and titrated to an Observer’s Assessment of Alertness/Sedation (OAAS) score of 1–2 (responds only after mild prodding or no response to prodding or shaking). Recovery was assessed objectively by OAAS and subjectively by visual analog scale (VAS). Results There is no significant difference in intraoperative parameters regarding the heart rate, the mean arterial blood pressure, the respiratory rate, and SpaO2 between group D (dexmedetomidine) and group P (propofol). Yet the induction time to the desired level of sedation was significantly shorter in group P compared with group D. Most of the group D patients returned postoperatively to an OAAS score of 5 earlier than group P patients. Group D showed a significantly lower VAS as compared with group P at 1 and 2 h postoperatively, whereas there was no significant difference in the VAS between the two groups at 3 h postoperatively. Conclusion Both propofol and dexmedetomidine are useful and safe for short-period procedural sedation; yet dexmedetomidine has a more rapid induction time of sedation than propofol, better analgesic effect with similar hemodynamic effects, better preservation of respiratory function, and rapid recovery. Thus, dexmedetomidine is a good alternative for short-period procedural sedation such as in ultrasound-guided oocyte pickup.