This study aims to compare the antinociceptive effects of ketamine and magnesium used in addition to midazolam, fentanyl, propofol and remifentanil agents preferred in hysteroscopy cases. It is conducted to observe the effect of ketamine and magnesium use on total additional propofol doses and additional remifentanil doses.

Sedation is generally preferred in hysteroscopy cases. The most commonly used intravenous drugs are midazolam, fentanyl, propofol and remifentanil. Multimodal analgesia, which is intended to be provided in hysteroscopy cases, is a strategy that includes the use of two or more analgesic agents and techniques to provide adequate analgesia; and aims to minimize side effects such as bradycardia, hypotension, respiratory depression, pruritus, and postoperative nausea and vomiting. Multimodal analgesia improves patient and surgical comfort by applying additional drugs to existing agents, reduces postoperative complications, and thus helps to shorten hospital stays and reduce costs. Whether magnesium contributes to this multimodal analgesia will be investigated observationally, based on its antinociceptive effects.

Inclusion Criteria:

1. ASA I-II patients
2. Patients aged 18-55
3. Patients undergoing hysteroscopy

Exclusion Criteria:

1. Patients who develop surgical complications during hysteroscopy
2. Patients with cardiovascular failure (ejection fraction <40%, patients with atrioventricular conduction disorder
3. Patients with history of cerebrovascular disease
4. Liver dysfunction (transaminases above normal level), Renal failure (creatine > 150 μmol/L),
5. Preoperative opioid use
6. History of neuromuscular disease
7. History of drug or alcohol abuse
8. Patients who develop the need for endotracheal intubation

Patients receiving sedation for gynecological hysteroscopic surgery in the gynecology operating room of Ankara Etlik City Hospital