BackgroundDaytime hysteroscopy requires anesthesia that offers rapid onset and clearance, with minimal respiratory and cardiovascular suppression. This study compared the effects of different doses of alfentanil combined with propofol target-controlled infusion (TCI) for such procedures. MethodsWe randomized 240 patients undergoing daytime hysteroscopy into three groups to receive alfentanil at doses of 5 μg/kg, 10 μg/kg, and 15 μg/kg, combined with propofol TCI. We meticulously recorded complications and perioperative vitals to evaluate the safety and efficacy of each dosage regimen. ResultsThe 10 μg/kg dose of alfentanil, used in conjunction with propofol, required lower propofol dosages and resulted in quicker recovery time and fewer intraoperative movements. However, higher doses of 15 μg/kg led to a significant increase in hypoxemia and instability in hemodynamics and oxygenation. ConclusionCombining alfentanil at 10 μg/kg with propofol TCI for daytime hysteroscopy results in high effectiveness. A lower incidence of complications, a reduced propofol requirement, and rapid emergence from sedation characterize this regimen.