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.
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.
