No abstract

Background/Aims: A hysterosalpingogram is an integral part of the evaluation of infertility, however, it is often painful. Methods: We conducted a randomized double-blinded, placebo-controlled trial of intravenous infusion of remifentanil in women undergoing hysterosalpingography (HSG). We randomly allocated 62 patients scheduled for HSG to receive either a continuous infusion of 0.25 µg·kg^–1 of remifentanil or placebo. The degree of pain was documented via 10-cm visual analog scales (VAS). Patients’ discomfort, side effects and recovery times were also recorded. Results: The VAS scores during HSG were 1.25 ± 1.31 in the remifentanil group and 4.78 ± 1.7 in the placebo group (p < 0.001). There were more patients in the remifentanil group that rated their condition as excellent (p < 0.001). The groups did not differ with regard to the incidence of side effects. The recovery times were found statistically longer in the remifentanil group (14 ± 5 vs. 10 ± 3 min). All the patients were discharged 30 min after the procedures without any side effects. Conclusion: Remifentanil infusion during HSG is superior to placebo for relief of pain with minimal opioid side effects.

Objective: To assess the probable agents affecting middle ear pressure in intubated patients hospitalized in intensive care units with various diagnoses.Methods: Middle ear pressure of 38 patients hospitalized in intensive care units within our faculty hospital was measured using portable tympanograms and acoustic reflectometry. The mode of the device to which each patient was attached and patients' blood pressure, Glasgow Coma Score, and additional disease parameters other than admission diagnosis were recorded. All data collected were subjected to statistical analysis to determine whether or not they affected middle ear pressure.Results: Septal deviation, survey, and mode of automatic respiratory device emerged as factors affecting middle ear pressure (odds coefficient 4.796, 3.745, 2.557, respectively, with 95% CI). Although aged over 60, additional disease and nasogastric tube also compromised middle ear pressure; the levels involved were not statistically significant. Conclusion:Middle ear pressure in patients hospitalized in intensive care units may change, particularly after the seventh day. This may particularly involve septal deviation, survey, and mode of automatic respiratory device, and tympanograms and reflectometry may be added to the patient-monitoring protocol in terms of changes in middle ear pressure.