Comparison of the effect of two drug combinations remifentanil propofol and ketamine propofol on hemodynamic parameters and reproductive outcome after intracytoplasmic sperm injection in patients undergoing oocyte retrieval with general anesthesia a double blind randomized clinical trial

The aim of this study was to compare the effects of remifentanil propofol and ketamine propofol on hemodynamic parameters, recovery time and intracytoplasmic sperm injection outcome in patients undergoing general anesthesia for oocyte retrieval.

An controlled, double blind, randomized clinical trial with a parallel-group design of 200 patients, enrolled between 2021 and 2023.

The present double-blind study will be performed at Mehr Medical Institute. Induction of anesthesia will be done in group remifentanil propofol with propofol 2 mg/kg and remifentanil 1 to 1.5 μg/kg and in the group ketamine propofol, ketofol containing propofol 1 to 1.5 mg/kg with 0.5 mg/kg of ketamine. Lidocaine 40 mg is prescribed to reduce the pain of propofol injection. The patient knows exactly two drugs and generally knows the methods and drugs, but does not know exactly which drug he has received. The analyzer is also unaware of the two groups. The specialist doctor is aware of two groups.

Inclusion: American Society of Anesthesiologists Classification grade I and II Age less than 42 years Exclusion: Signs of poor ovarian response Preimplantation genetic screening cycles History of cardiorespiratory disease Chronic drug use Allergy to anesthetics

Intervention group: Induction of anesthesia in intervention group will be done with propofol 1 to 1.5 mg/kg and ketamine 0.5 mg/kg Control group: Induction of anesthesia in control group will be done with propofol 2 mg/kg and remifentanil 1 to 1.5 μg/kg.

Fertilization rate, clinical pregnancy

Block randomization will be done using computer software. The list of blocks will be written and numbers will be assigned to them (AABB (1) - ABAB (2) -ABBA (3) -BBAA (4) - BABA (5) - BAAB (6)), then random numbers between one and six ( For example, 1 4 5, etc.) will be select and finally the treatment allocation list based on previous random numbers (AABB, BBAA, BABA, etc.) will be specified.

At the anesthesia visit, all the conditions of the study will be explained by a respected anesthesiologist. If the patient wishes to participate in the study, written consent will be obtained. The patient knows exactly two drugs and generally knows the methods and drugs, but does not know exactly which drug he has received. The analyzer is also unaware of the nature of the two groups. The specialist doctor is aware of two groups.