Different Doses of Esketamine Combined with Propofol for Pain Control and Pregnancy Outcomes in Oocyte Retrieval:A Single Center Study

YIN Yina; QIAN Min; GAO Mingchen; LI He; XU Huijie

doi:10.3639/j.issn.2095-3097.2024.11.057

Abstract：Objective Transvaginal oocyte retrieval under ultrasound guidance is an important technical aspect in the treatment of infertility,and the appropriate anesthesia method is significant for alleviating puncture pain and improving prog-nosis.This study investigated the pain-relieving effects of different doses of esketamine combined with propofol anesthesia and its impact on pregnancy outcomes in oocyte retrieval patients.Methods Altogether 273 patients scheduled to undergo ul-trasound-guided TVOR were randomly assigned.The control group received anesthetic induction with remifentanil 0.2 μg/kg combined with propofol 2 mg/kg,while the different dose groups of esketamine included three subgroups ES1,ES2,ES3,with doses of(0.2,0.3,0.5 mg/kg)respectively,also combined with propofol 2 mg/kg for anesthetic induction.During the procedure,anesthesia was maintained with an intravenous infusion of propofol at 8-12 mg/(kg·h).Major parameters recorded to evaluate the effect of esketamine include embryo implantation rate,pregnancy rate,and postoperative pain scores.Results Differ-ent doses of esketamine in combination with propofol anesthesia reduced the emergence duration,decreased the amount of propofol used during surgery(P<0.001),maintained follicle quality,substantially ameliorated the postoperative pain without affecting the prognosis.Importantly,higher doses of esketamine demonstrated better analgesic effects,reduced intraoperative bodily movements,and alleviated postoperative pain(P<0.001).Conclusion Administering esketamine before ul-trasound-guided TVOR in patients under propofol anesthesia effectively alleviates pain without adversely affecting the clinical pregnancy rate.