AZİZ YARBİL, RAUF GUL, VAHAP SARİCİCEK, LEVENT SAHİN, METİN KİLİNC, ERGUN MENDES, HUSEYİN GOCERGİL, MUHARREM BATURU
Eurasian Clinical and Analytical Medicine - 2025;13(3):70-74
Aim: We aimed to investigate the efficacy and safety of transurethral resection (TUR) under monitored anesthetic care (MAC) and the effective dose of remifentanil. Material and methods: In this prospective, randomized, controlled trial, 50 patients were randomized to undergo TUR under monitored anesthetic care MAC. Vital signs were recorded at baseline and at 1, 5, 10, 15, 20, 30, 40, 50, and 60 minutes after induction. During induction, all patients received propofol at 1 mg/kg/h and remifentanil at 0.25 µg/kg/h. Following induction, Group 1 received a remifentanil infusion at 3 µg/kg/h, and Group 2 received 6 µg/kg/h. The depth of anesthesia was monitored using bispectral index (BIS) monitoring. Intraoperative and postoperative side effects, surgeon satisfaction, propofol consumption (PC), and recovery time were also recorded. Results: In our study, effective sedation and analgesia were achieved in both groups. However, intraoperative depth of anesthesia (p = 0.03), postoperative recovery time (p = 0.017), and surgeon satisfaction (p = 0.019) were better in Group 2. Hemodynamic and side effects were similar between the groups (p > 0.05). No adverse events were observed in any patient that would negatively affect the surgical procedure. SpO2 values were transiently lower in Group 1 at 1, 5, and 15 minutes, but these differences were not statistically significant. BIS scores in group 2 were statistically lower than group 1 at all measurement times (p = 0.02). Group 2 demonstrated significantly shorter awakening and recovery times. Discussion: We think that TUR procedures using both remifentanil doses can be preferred under MAC. Both regimens were safe and effective; however, Group 2 demonstrated better hemodynamic stability, deeper sedation, higher surgeon satisfaction, and faster recovery.
