Conscious sedation for oocyte retrieval: Experience at a tertiary health facility in North-Central, Nigeria

L. Omokanye, A. Olatinwo, K. Durowade, A. Panti, Ganiyu Salaudeen
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引用次数: 1

Abstract

Background: A variety of anesthetic techniques have been used to make transvaginal oocyte retrieval (TVOR) safe and efficient. The optimal anesthetic technique during TVOR should provide safe, effective analgesia, few side effects, a short recovery time, and be nontoxic to the oocytes that are being retrieved. The concept of conscious sedation is widely accepted for the short-term management of pain. Objective: This study assessed patient's perception of pain using conscious sedation and in-vitro fertilization (IVF) outcomes. Materials and Methods: A cross sectional study of 71 eligible patients that underwent assisted reproduction program in our facility. All clients were treated with antagonist protocol for controlled ovarian hyperstimulation. Self-administered questionnaires were used as the research instrument. Pain was assessed using a 10 cm visual analogue scale (VAS), while client's overall satisfaction was rated using Likert scoring system. Results: Client aged 33.2 ± 4.2 years. Most of them had primary infertility with mean duration of 4.5 ± 2.9 years. Unexplained infertility was the commonest cause of infertility. The pregnancy rate per embryo transfer was 47.9%, miscarriage rate was 5.6%, while the live birth rate was 42.3%. The mean VAS scores at 1 h, 6 h, 24 h and at embryo transfer were 4.9 ± 1.7, 2.5 ± 1.2, 1.3 ± 0.9, and 0.5 ± 0.6, while the Likert score was 3.8 ± 1.1. Conclusion: Conscious sedation with Midazolam and Pethidine is a safe, effective, and acceptable method of analgesia/anesthesia for TVOR. However randomized prospective studies with larger sample sizes are recommended.
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有意识镇静以获取卵母细胞:尼日利亚中北部三级卫生设施的经验
背景:多种麻醉技术已被用于使经阴道取卵(TVOR)安全有效。TVOR过程中的最佳麻醉技术应提供安全、有效的镇痛,副作用少,恢复时间短,并且对回收的卵母细胞无毒。清醒镇静的概念被广泛接受用于短期疼痛管理。目的:本研究使用清醒镇静和体外受精(IVF)结果评估患者的疼痛感知。材料和方法:对在我们机构接受辅助生殖计划的71名符合条件的患者进行横断面研究。所有患者均接受对照性卵巢过度刺激拮抗剂方案治疗。采用自我管理问卷作为研究工具。使用10cm视觉模拟量表(VAS)评估疼痛,同时使用Likert评分系统对客户的总体满意度进行评分。结果:患者年龄33.2±4.2岁。多数为原发性不孕,平均病程4.5±2.9年。不明原因的不孕是导致不孕的最常见原因。每次胚胎移植的妊娠率为47.9%,流产率为5.6%,活产率为42.3%。1小时、6小时、24小时和胚胎移植时的平均VAS评分分别为4.9±1.7、2.5±1.2、1.3±0.9和0.5±0.6,而Likert评分为3.8±1.1。结论:咪唑安定和哌替啶的清醒镇静是一种安全、有效、可接受的TVOR镇痛/麻醉方法。然而,建议进行样本量较大的随机前瞻性研究。
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