Recommendations for good practice for sedation in assisted conception

Acharya, Umesh; Elkington, Nick; Manning, Louisa; Thorp-Jones, D.; Tavener, G.

doi:10.1080/14647273.2019.1596245

Cited by 10 publications

(6 citation statements)

References 31 publications

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“…This likely contributes to the low sedation related complication rate in these women. Given sedation is a continuum, and the variation in individual patient response which cannot always be predicted, the safest approach is to administer sedation in small incremental doses and titrate to a desired response (10,17). Additionally, a contingency plan must be in place in cases where the level of sedation becomes deeper than initially intended (10).…”

Section: Discussionmentioning

confidence: 99%

Impact of class III obesity on outcomes and complications of transvaginal ultrasound-guided oocyte pickup

et al. 2020

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Objective: To assess the impact of class III obesity on outcomes and complications of transvaginal ultrasound-guided oocyte pickup (OPU). Design: Retrospective cohort study. Setting: Hospital-based fertility clinic. Patient(s): All women undergoing OPU procedures during autologous in vitro fertilization (IVF) and oocyte banking cycles, grouped by patient body mass index (BMI: <25, 25-29.9, 30-34.9, 35-39.9, R40 kg/m 2). Intervention(s): Transvaginal OPU under conscious sedation. Main Outcome Measure(s): Sedation and procedure-related parameters and complications. Result(s): A total of 2,141 OPU procedures in 1,579 patients were analyzed, including 121 OPU procedures in 94 patients with BMI R40 kg/m 2. There was a statistically significant increase in total fentanyl and midazolam doses and procedure duration as BMI increased. Compared with patients with BMI <25 kg/m 2 , those with BMI R40 kg/m 2 were more likely to require additional sedation during the procedure (adjusted odds ratio [aOR] 1.99; 95% confidence interval [CI], 1.14-3.49). The rate of difficult access was 28.9% for procedures with BMI R40 kg/m 2 compared with 5.2% with BMI <25 kg/m 2 (aOR 7.57; 95% CI, 4.66-12.29). The OPU was incomplete due to inaccessible follicles through a transvaginal approach in 18.2% of procedures with BMI R40 kg/m 2 compared with 1.3% with BMI <25 kg/m 2 (aOR 16.94; 95% CI, 8.24-34.84). The rates of sedation and procedure-related complications were low, and none occurred in patients with BMI R40 kg/m 2. Conclusion(s): There was no increased risk of complications for women with class III obesity undergoing OPU with conscious sedation. However, the operator was more likely to encounter difficult access and to incompletely aspirate follicles through a transvaginal approach. (Fertil Steril Rep Ò 2020;1:270-6. Ó2020 by American Society for Reproductive Medicine.

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Section: Discussionmentioning

confidence: 99%

Impact of class III obesity on outcomes and complications of transvaginal ultrasound-guided oocyte pickup

et al. 2020

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“…Also, in this issue, we publish an update to the British Fertility Society 'Recommendations for Good Practice for sedation in Assisted Conception' (Acharya, 2020). This replaces the previous version of the guidelines published by Elkington et al (2003) and is a welcome update.…”

Section: Impact Factormentioning

confidence: 98%

2019 Impact factor

Pacey

2020

Human Fertility

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“…Against this background and to protect access to services, BPAS successfully accelerated an expansion of the use of CS in dilatation and evacuation abortion up to 17 weeks+6 days 8. In late 2021, BPAS will launch its fertility service and will employ CS for egg collections 9. BPAS is interested in exploring the potential for CS in other painful or anxiety-producing interventions that are often provided without anaesthetic (eg, cervical smears) or under LA (eg, intrauterine device insertion), in addition to nurse-delivered sedation 10…”

Section: The Future – Where Do We Go From Here?mentioning

confidence: 99%