Propofol

In Yuan et al study,^{[29 (link)]} patients received standardized general anesthesia and basic analgesic protocol. Intraoperatively, all patients received general anesthesia which was induced by sufentanil 0.5 μg/kg, midazolam 0.04 mg/kg, propofol 1 to 2 mg/kg, and Cisatracurium 2 μg/kg intravenously, followed by continuous intravenous infusion of remifentanil 0.1 to 0.3 μg/(kg·min), propofol 2 to 5 mg/(kg·hr) and inhalation of sevoflurane to maintain anesthesia. Since postoperative day 1, the protocol of oral celecoxib restarted till postoperative 3 weeks when the patients came back to the hospital for taking out the stitches. In Yadeau et al 2016 study,^{[6 (link)]} patients received a standardized anesthetic and multimodal analgesic protocol. In Yadeau et al 2022 study,^{[28 (link)]} patients received a standard intraoperative and postoperative multimodal anesthetic protocol: a spinal-epidural (subarachnoid mepivacaine, 45–60 mg); adductor canal block (ultrasound-guided; 15 cc bupivacaine, 0.25%, with 2 mg preservative-free dexamethasone). For postoperative pain management, patients were scheduled to receive the study medication once daily for 14 days; 4 doses of 1000 mg IV acetaminophen every 6 hours followed by 1000 mg oral acetaminophen every 8 hours; 4 doses of 15 mg IV ketorolac followed by 15 mg meloxicam every 24 hours; and 5 to 10 mg oral oxycodone was given as needed for pain. Patients could have pain medications adjusted as indicated. In Koh et al study,^{[12 (link)]} all patients had a postoperative intravenous patient-controlled anesthesia (PCA) pump that administered 1 mL of a 100-mL mixture containing 2000 mg of fentanyl on demand. In Kim et al study,^{[27 ]} all patients received intravenous PCA encompassing delivery of 1 mL of a 100 mL solution containing 2000 µg of fentanyl postoperatively. In Ho et al study,^{[26 (link)]} patients were routinely offered a single shot spinal anesthesia consisting of an intrathecal dose of bupivacaine 10 to 12.5 mg with fentanyl 10 mg. After surgery, pain treatment consisted of PCA with intravenous injection of morphine. The settings were 1 mg bolus, 5 minutes lockout time, and a maximum hourly limit of 8 mg. All patients were also given acetaminophen 1 g 6 hourly.

The study was approved by the Ethics Committee of Weifang People’s Hospital and registered at http://www.chictr.org.cn (Chinese Clinical Trial Registry, ChiCTR2200057803). The study protocol followed the CONSORT guidelines. The study protocol was performed in the relevant guidelines. Informed consent was signed by the patients and their families who participated in the study.
Patients proposed for hysteroscopy day surgery under total intravenous anesthesia, aged 18 to 65 years, American Society of Anesthesiologists (ASA) grade I or II were selected. Exclusion criteria were breastfeeding, a history of chronic pain, a history of sedative and analgesic administration or allergy to any of the study drugs, severe hypertension, and diabetes mellitus. Reject criteria were a procedure time of more than 1 hour, discharged the next day, missing follow-up with the electronic questionnaire pushed 24 hours after the procedure. The included patients were randomized into 3 groups: dexamethasone plus saline group (DC group), dexamethasone plus droperidol group (DD group) and dexamethasone plus propofol group (DP group). The DC group was used as the control group and the remaining 2 groups as the intervention group. Random allocation of included patients by an independent researcher using Excel 2016 (Microsoft) with a 1:1:1 allocation. The participating patients, the outcome assessment fellows, were unaware of the group allocation, only the doctor administering the anesthetic was aware of the grouping of patients and all patients were anesthetized by the same anesthetist.
Patients were routinely fasted and no pre operative medication was administered. After the patient entered the operating room, the intravenous channel was established, and the patient’s ECG, SPO₂, NIBP, and BIS were monitored. Patients in each group were given dexamethasone 5 mg for anti-inflammatory and antiemetic prophylaxis before induction, and flurbiprofen axetil 50 mg for preemptive analgesia. Induction of anesthesia: remimazolam 6 mg/kg/hours was continuously infused until sleep, and then mivacurium 0.2 mg/kg and alfentanil 20 ug/kg were slowly injected, after 3 minutes of mask ventilation, the laryngeal mask was placed by the anesthesiologist and mechanical ventilation was performed. Anesthesia maintenance: alfentanil 40 ug/kg/hours and remimazolam 1 mg/kg/hour continuous infusion, stop infusion at the end of the operation. BIS value was maintained between 40 and 60, and 0.1 mg/kg of mivacurium was injected intermittently when necessary. After the start of surgery DC group was given 2ml saline, DD group was given droperidol 1 mg, and DP group was given propofol 20 mg. After awakening and extubation, the patient was taken to the postanesthesia care unit (PACU) and assessed for nausea and vomiting. Patients were discharged after meeting discharge criteria as assessed by the Post-anesthetic Discharge Scoring System (PADSS) criteria. An electronic follow-up questionnaire was pushed 24 hours after the operation. Basic information about the patient’s medical history and surgery was obtained through pre operative anesthesia clinic assessment, intraoperative anesthesia monitoring, in the inpatient electronic medical record, and observation notes in the PACU.