A comparison of two different regimens of total intravenous anesthesia for transvaginal ultrasound-guided oocyte retrieval

Saleh, Shafik E.; Elshmaa, Nagat S.; Ismail, M.

doi:10.1016/j.mefs.2012.07.003

Cited by 8 publications

(4 citation statements)

References 17 publications

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“…Though in neither group did any complication linked to intraoperative movement of patients develop, the significantly lower rate of movement in the BIS group shows that BIS monitoring can reduce the development of complications. Additionally, the additional propofol consumption in the groups after induction was significantly lower in BIS group compared to control group, similar to the results of studies by Circeo et al and Saleh et al on BIS monitoring for OPU procedures (3,19). The recovery duration was significantly shorter in the BIS group compared to the control group.…”

Section: Discussionsupporting

confidence: 87%

Efficacy of bispectral index monitoring for prevention of anestheticawareness and complications during oocyte pick-up procedure

Urfalıoğlu¹,

Arslan²,

Bakacak³

et al. 2017

Turk J Med Sci

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Background/aim: This study was planned by considering that the use of bispectral index (BIS) monitoring ensures sufficient depth of anesthesia and avoids anesthetic awareness and patient movement in the oocyte pick-up (OPU) procedure.Materials and methods: Ninety-eight patients undergoing OPU were randomly divided into 2 groups as the control group (n = 48) and BIS group (n = 50). After propofol and remifentanil induction, the control group was given additional propofol according to reaction response, while the BIS group was given propofol at BIS values of 60 and above with the aim that BIS values be 40-60. Total procedure time, recovery time, patient movement, additional propofol consumption, total number of oocytes, and awareness during anesthesia were recorded.Results: Demographic data were similar in the two groups (P > 0.05 for all). The recovery time in the BIS group was significantly shorter compared to the control group (P < 0.001) while additional propofol consumption was found to be significantly lower (P < 0.001). Baseline BIS values fell compared to all other times after induction significantly (P < 0.001). No patient had anesthesia awareness. Conclusion:During the OPU procedure BIS monitoring is considered to prevent anesthesia awareness, intraoperative movement, and complications caused by insufficient anesthetic use as it ensures optimal doses of anesthetic agents used and early recovery.

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Section: Discussionsupporting

confidence: 87%

Efficacy of bispectral index monitoring for prevention of anestheticawareness and complications during oocyte pick-up procedure

Urfalıoğlu¹,

Arslan²,

Bakacak³

et al. 2017

Turk J Med Sci

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“…In one RCT, a higher dose of remifentanil was associated with a significant increase in apnoea, and need for mechanical ventilation. Different combinations of agents and administration routes for CSA, general anaesthesia (GA) or spinal anaesthesia were compared in 12 RCTs (Godoy et al, 1993;Casati et al, 1999;Martin et al, 1999;O ¨cal et al, 2002;Guasch et al, 2005;Hong et al, 2007;Ma et al, 2008;Saleh et al, 2012;Coskun et al, 2017;Elnabtity and Selim, 2017;Morue et al, 2018, Lai et al, 2020, of which 10 (83%) showed a significant benefit for one of the combinations used. A formal comparison of these outcomes is beyond the scope of this review, but it is important to realize that use of different agents and administration routes of the same category of sedatives or analgesics may need to be studied further to find the optimal combination in this population.…”

Section: Interventions and Significant Resultsmentioning

confidence: 99%

Trends in research on pain relief during oocyte retrieval for IVF/ICSI: a systematic, methodological review

Buisman

Grens

Wang

et al. 2022

Human Reproduction Open

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STUDY QUESTION What is the methodological validity and usefulness of randomised controlled trials (RCTs) on pain relief during oocyte retrieval for IVF and ICSI? SUMMARY ANSWER Key methodological characteristics such as randomisation, allocation concealment, primary outcome measure, and sample size calculation were inadequately reported in 33 to 43% of the included RCTs, and a broad heterogeneity is revealed in the studied outcome measures. WHAT IS KNOWN ALREADY A Cochrane review on conscious sedation and analgesia (CSA) for women undergoing oocyte retrieval concluded that the overall quality of evidence was low or very low, mainly owing to poor reporting. This, and heterogeneity of studied outcome measures limits generalisability, and eligibility of results for meta-analysis. STUDY DESIGN, SIZE AND DURATION For this review, a systematic search for RCTs on pain relief during oocyte retrieval was performed on July 20th 2020 in CENTRAL CRSO, MEDLINE, Embase, PsycINFO, CINAHL, ClinicalTrials.gov, WHO ICTRP, Web of science, Portal Regional da BVS, and Open Grey. PARTICIPANTS/MATERIALS, SETTING, METHODS RCTs with pain or patient satisfaction as an outcome were included and analysed on a set of methodological and clinical characteristics, to determine their validity and usefulness. MAIN RESULTS AND THE ROLE OF CHANCE Screening of 2531 articles led to an inclusion of 51 RCTs. Randomisation was described inadequately in 33% of the RCTs. A low-risk method of allocation concealment was reported in 55% of the RCTs. Forty-nine percent of the RCTs reported blinding of participants, 33% of blinding personnel, and 43% of blinding the outcome assessor. In 63% of the RCTs, the primary outcome was stated, but a sample size calculation was described in only 57%. Data was analysed according to the intention-to-treat principle in 73%. Treatment groups were not treated identically other than the intervention of interest in 10% of the RCTs. The primary outcome was intraoperative pain in 28%, and postoperative pain in 2%. The visual analogue scale (VAS) was the most used pain scale, in 69% of the RCTs in which pain was measured. Overall, nine other scales were used. Patient satisfaction was measured in 49% of the RCTs, for which 12 different methods were used. Occurrence of side-effects and complications were assessed in 77% and 49% of the RCTs: a definition for these was lacking in 13% and 20% of the RCTs, respectively. Pregnancy rate was reported in 55% of the RCTs and, of these, 75% did not adequately define pregnancy. To improve the quality of future research, we provide recommendations for the design of future trials. These include use of the VAS for pain measurement, use of validated questionnaires for measurement of patient satisfaction, and the minimal clinically relevant difference to use for sample size calculations. LIMITATIONS, REASONS FOR CAUTION Consensus has not been reached on some methodological characteristics, for which we formulated recommendations. To prevent further heterogeneity in research on this topic, recommendations were formulated based on expert opinion, or on the most used method thus far. Future research may provide evidence to base new recommendations on. WIDER IMPLICATIONS OF THE FINDINGS Use of the recommendations given for design of trials on this topic can increase the generalisability of future research, increasing eligibility for meta-analyses, and preventing wastefulness. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was obtained for this study. S.B. reports being the editor-in-chief of Human Reproduction Open. For this manuscript, he was not involved with the handling process within Human Reproduction Open, or with the final decision. Further, S.B. reports personal fees from Remuneration from Oxford University Press as editor-in-chief of Human Reproduction Open, personal fees from Editor and contributing author, Reproductive Medicine for the MRCOG, Cambridge University Press. The remaining authors declare no conflict of interest in relation to the work presented. TRIAL REGISTRATION NUMBER Not applicable.

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“…3,5 Spontan solunumun devam ettiği ancak yeterli analjezik ve sedatif etkilerin sağlanabildiği derin sedasyon uygulamaları diğer girişimsel işlemlerde olduğu gibi daha uygun olabilir. 6,7 Hedef kontrollü infüzyon (HKİ) cihazı ile remifentanil ve propofol infüzyonu değişik girişim-sel uygulamalarda sedasyon ve analjezi sağlamak amacı ile kullanılmıştır. 6,8 Bu uygulamalarda propofol midazolam, fentanil, alfentanil ve remifentanil tek başına uygulanabildiği gibi, değişik kombinasyonları yapılacak cerrahi işlemin durumuna göre farklı dozlarda test edilmiştir.…”

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“…Bu amaçla fentanil ve alfentanil kullanılmakla birlikte son yıllarda kısa etkili olması ve derlenme süresini kısaltmasından dolayı remifentanil de tercih edilmektedir. 7,8 Sarıkaya ve ark.nın oosit toplama işlemlerinde propofol infüz-yonuna 0,1 ve 0,015 mcg/kg/dk remifentanil infüzyonu ekledikleri çalışmalarında, her iki dozda da işlem sırasında hemodinamik stabilizasyon ve sorunsuz derlenme sağlandığı gözlemlenmiştir. 19 HKİ cihazları kullanıma girdiğinden beri stabil bir plazma konsantrasyonu sağlamalarından dolayı anesteziden sonra sedasyon uygulamalarında da popülerlik kazanmıştır.…”

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Deep Sedation with Propofol and Remifentanil Using the Target Controlled Infusion System During Oocyte Retrieval

Karabayırlı¹,

Kösem²,

Özanbarci³

et al. 2015

Turkiye Klinikleri J Anest Reanim

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Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada amacımız, hedef kontrollü propofol infüzyonu uygulamasına hedef kontrollü remifentanil infüzyonu eklenmesinin propofol tüketimi ve işlemin uygulama kolaylığına katkısını araştır-maktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Standart ovarian stimülasyon almış olan ve elektif oosit toplama işlemi operasyonu planlanan ASA I-II, 40 hasta çalışmaya dâhil edildi ve randomize olarak iki gruba ayrıldı. Tüm hastalara Grup P ve grup PR'ye hedef kontrollü infüzyon cihazı ile plazma konsatrasyonu (Cp) 4 µg/mL plazma konsantrasyonu olacak şekilde propofol infüzyonu uygulandı. Grup P'ye plasebo infüzyon, Grup PR'ye ise Cp 1 ng/mL olacak şekilde remifentanil infüzyonu eklendi. Bazal, indüksiyondan sonra üçüncü ve beşinci dakika aralıklar ile kalp hızı (KH), ortalama arter basıncı (OAB) ve oksijen satürasyonu takip edildi. Derlenme süresi, işlem sonrası hatırlama, ağrı, bulantı olup olmadığı, fertilizasyon oranları, cerrah ve hasta memnuniyeti kaydedildi. B Bu ul lg gu ul la ar r: : Gruplar arası demografik verilerinin karşılaştırmasında istatistiksel anlamlı fark saptanmadı (p>0,05). Girişim sırasında indüksiyon sonrasından itibaren grup PR'de KH ve OAB değerlerinin Grup P'ye göre daha düşük olduğu tespit edildi (p<0,05). Gruplar arasında solunum depresyonu gelişimi açısından istatistiksel anlamlı fark saptanmadı (p=0,342). İşlem sırasında grup P'de hastalarda daha fazla istemsiz hareket ve propofol dozu ayarlama ihtiyacı gözlendi (p<0,005). Gruplar arasında derlenme sü-releri, postoperatif bulantı kusma ve sözel değerlendirme ölçeği ile ağrı değerlendirmelerinde fark gözlenmedi (p>0,05). Cerrahın işlemi uygulama kolaylığı ve hastaların anestezi konforu değerlendirmelerinde ve fertilizasyon parametrelerinde gruplar arasında anlamlı fark saptanmadı (p>0,05). S So on nu uç ç: : Oosit toplama işlemle-rinde spontan solunumun korunduğu hedef kontrollü propofol sedasyonu uygulamasına 1 ng/mL plazma konsantrasyonu gibi düşük dozda remifentanil infüzyonu eklenmesinin propofol doz ayarlama ihtiyacını azalttığı ve girişim sırasında istemsiz hareket açısından yararlı olacağı kanısındayız.

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A comparison of two different regimens of total intravenous anesthesia for transvaginal ultrasound-guided oocyte retrieval

Cited by 8 publications

References 17 publications

Efficacy of bispectral index monitoring for prevention of anestheticawareness and complications during oocyte pick-up procedure

Efficacy of bispectral index monitoring for prevention of anestheticawareness and complications during oocyte pick-up procedure

Trends in research on pain relief during oocyte retrieval for IVF/ICSI: a systematic, methodological review

Deep Sedation with Propofol and Remifentanil Using the Target Controlled Infusion System During Oocyte Retrieval

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