This prospective, randomized, double-blind study was carried out to compare the effect of remifentanil with that of alfentanil, as a part of total intravenous anesthesia (TIVA) on the hemodynamic profile, recovery characteristics, visual analogue scale (VAS) for postoperative pain, and serum cortisol changes in the patients undergoing oocyte retrieval.

The patients were assigned to receive either propofol-remifentanil (n = 31) or propofol-alfentanil (n = 30). When the target propofol concentration (3.0 µg/ml) was reached, the study drugs were administered over a 60 s period with the loading dose (either remifentanil 1 µg/kg or alfentanil 10 µg/kg) and were maintained with a continuous infusion (either remifentanil 0.08 µg/kg/min or alfentanil 0.4 µg/kg/min). The propofol requirements, blood pressure, pulse rate, serum cortisol, VAS scores for pain, recovery profile and postoperative side effect were recorded in both the operating and recovery rooms.

There were significant differences in the VAS score for postoperative pain 30 minutes after oocyte retrieval between the two groups.

The propofol-remifentanil and propofol-alfe ntanil techniques are suitable for oocyte retrieval but the propofol-remifentanil technique requires additional analgesics for postoperative pain due to the rapid offset of remifentanil.