Objective: The aim of this study was to evaluate the success of intrauterine insemination (IUI) treatment, the factors affecting success, and current recommendations. Methods:This study was conducted by retrospectively investigating 300 cycles of IUI treatment performed in 183 patients between 2005 and 2009. The results of a single IUI treatment session performed 32 to 36 hours after a dose of 10,000 units of chorionic gonadotropin was administered to patients with unexplained infertility were analyzed. The patients were aged between 19 and 42 years with a median follicle-stimulating hormone test result of 7.15 mIU/L, a total motile sperm count exceeding 5 million/mL, and a follicle size of at least 15 mm with treatment. Results:The successful pregnancy rate with spontaneous coitus after clomiphene citrate (CC) treatment was 12.5% (13/104) The successful pregnancy rate with IUI after CC treatment was 11.7% (16/136), and the successful pregnancy rate with IUI after gonadotropin treatment was 23.4% (14/60). A total of 43/300 pregnancies were achieved and the overall success rate was 14.3%. When the results of the 43 pregnancies obtained were examined, 32 term pregnancies (10.7%) were achieved, there were 9 (3.0%) cases of abortus, 1 (0.7%) ectopic pregnancy, and 1 (0.7%) chemical pregnancy. Conclusion:CC is still the best agent for first-line treatment in couples with unexplained infertility. In cases refractory to gonadotropins, IUI promotes clinical success. IUI has the advantages of low cost, easy applicability and accessibility, low morbidity, and a significant success rate.

Background: This study aimed to compare remifentanil and ketamine-propofol in terms of hemodynamic response, duration of recovery and patient satisfaction in operative hysteroscopy cases who underwent monitored anaesthesia care in combination with paracervical block. Methods: Monitored anaesthesia care was used in 60 ASA I-II female patients. The patients were divided into two groups as remifentanil (Group R) and ketamine-propofol (Group K-P). The hemodynamic effects of remifentanil and ketamine-propofol, and duration of recovery were recorded and compared. The patient satisfaction was also recorded and the two groups were compared. Results: Age, body mass, ASA status, duration of anaesthesia and type of surgery were found to be similar between groups. The time of the Aldrete score reaching ≥ 9 was found to be shorter in Group R when compared with Group KP (Group R: 4.1 ± 1.9 min, Group K-P: 6.1 ± 2.6 min) (P < 0.05). The incidence of postoperative nausea and vomiting was found to be significantly higher in the remifentanil group (P ≤ 0.05). When the groups were compared in terms of patient satisfaction, in both groups this was found to be similar. Conclusion: Sedation with remifentanil combined with a paracervical block during monitored anaesthesia care provides early recovery with effective sedation and analgesia in hysteroscopy procedures.

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Spinal anestezi alt ekstremite cerrahilerinde sıklıkla yeğlenmektedir. Spinal anestezinin hasta konforunu bozan post spinal baş ağrısı gibi çeşitli komplikasyonlar bulunmaktadır. Biz bu çalışmada, heavy marcaine ilave edilen fentanilin post spinal baş ağrısı görülme sıklığı üzerine etkisini araştırmayı amaçladık. Gereç ve Yöntem: Variköz ven cerrahisi planlanan hastalar randomize iki gruba ayrıldı. Kontrol grubuna 15 mg hiperbarik bupivakain, çalışma grubuna 15 mg hiperbarik bupivakain+20 mcg fentanil uygulandı. Bulgular: İki yüz altı hastaya (116 erkek, 90 kadın) ait veri analiz edildi. Post spinal baş ağrısı görülme sıklığı gruplar arasında benzerdi. Post spinal baş ağrısı ile ilişkili olan değişkenlerin multivaryant regresyon analizinde boy, alkol kullanımı, deneme sayısı, girişim öncesi parsiyel oksijen satürasyon değeri ve girişim sonrası 10. dakika kalp hızı post spinal baş ağrısı için bağımsız risk faktörleri olarak saptandı. Sonuç: Spinal anestezi sırasında heavy marcaine ilave edilen 20 mcg fentanilin post spinal baş ağrısı üzerine etkisi bulunmadığını düşünmekteyiz. Ancak alkol kullanımı, lomber ponksiyon sayısı, bazal parsiyel oksijen satürasyon değeri ve girişim sonrası 10. dk. kalp hızı post spinal baş ağrısı için bağımsız risk faktörleri olarak saptandı. Bu değişkenlerle ilgili yeni çalışmalara gereksinim duyulduğu düşüncesindeyiz.

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