P298 Comparison of the effect of ketofol and ketodex as procedural sedation and analgesia for oocyte retrieval during in-vitro fertilisation procedures – a randomized controlled pilot study

<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted</b>: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission Application for ESRA Abstract Prizes <h3>Background and Aims</h3> Sedation for oocyte retrieval must provide effective analgesia without respiratory compromise or harm to embryo quality. We compared ketamine-propofol (Ketofol, KP) with ketamine-dexmedetomidine (Ketodex, KD), hypothesising that KD would match analgesia while reducing adverse effects and embryo quality. <h3>Methods</h3> In a single-centre, open-label, randomised trial, 60 ASA I–II patients (20–40 y) were assigned to KP or KD (30 each). KP received propofol 1 mg kg⁻¹ + ketamine 0.5 mg kg⁻¹, then propofol 3 mg kg⁻¹ h⁻¹. KD received dexmedetomidine 1 µg kg⁻¹ over 10 min + ketamine 0.5 mg kg⁻¹, followed by dexmedetomidine 0.3 µg kg⁻¹ h⁻¹; both regimens included ketamine 0.5 mg kg⁻¹ h⁻¹. Primary outcome was cumulative pain; secondary outcomes were rescue-opioid use, apnoea, postoperative nausea-vomiting (PONV) and embryological indices. <h3>Results</h3> Median pain scores remained ≤1 in both groups (p &gt; 0.05). Rescue fentanyl was required in 0% KD vs 60% KP (p &lt; 0.001). Apnoea occurred in 0% KD vs 53% KP (p &lt; 0.0001). PONV at 30 min was 3% KD vs 50% KP (p &lt; 0.0001). Fertilisation stayed at 100% in both arms, while day-3 cleavage favoured KD (87 ± 18% vs 78 ± 32%). Haemodynamic variables, satisfaction scores and discharge readiness were comparable. <h3>Conclusions</h3> Ketodex offers analgesia equivalent to Ketofol yet virtually eliminates opioid need, respiratory depression and early PONV without compromising embryo development. KD is therefore a safe, embryo-friendly alternative for procedural sedation during IVF oocyte retrieval.