Randomized double-blind clinical trial comparing two anesthetic techniques for ultrasound-guided transvaginal follicular puncture

Júnior, Gilvandro Lins de Oliveira; Serralheiro, Fernando César; Fonseca, Fernando Luiz Affonso; Ribeiro, Onésimo Duarte; Adami, Fernando; Christofolini, Denise Maria; Bianco, Bianca; Barbosa, Caio Parente

doi:10.1590/s1679-45082016ao3714

Cited by 9 publications

(5 citation statements)

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“…Oliveira et al, reported better rates of pregnancy, as well as fertilized oocytes and em-bryos obtained with the use of opioid and propofol against cervical blockad (7). Similar results were obtained in by Saxena in 2016, in which it was shown that the cervical block is ineffective as a single technique for performing puncture (8).…”

Section: Discussionmentioning

confidence: 64%

Effect of conscious anesthesia with remifentanil versus general anesthesia with propofol on embryo quality and pregnancy rate in ICSI

2022

pnr

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Background: Anesthesia is a corner of stone in invitro fertilization method for infertile couple and can be detrimental on the any results of reproduction due to potential toxici-ty run into by the anesthetic medications used. Objective: To assess the effect of con-scious anesthesia with remifentanil versus general anesthesia with propofol on embryo quality and pregnancy rate in ICSI. Material and methods: Comparative cross-sectional study that's enrolled Seventy infertile female who were enduring intra cyto-plasm sperm injection technique (ICSI) at the infertility center of High Institute for In-fertility Diagnosis and Assisted Reproductive Technique /Al-Nahrain University / Baghdad / Iraq, during a period from November 2021 until May 2022. The present study enrolled Seventy infertile females undergoing ICSI cycles with an age range of 19 to 40 years and an infertility duration ranging from 2 years to 10 years.Results: Mean level of day of embryo transferred was 2.5± 0.662 in conscious group and 2.59± 0.56 in GA group with no significant difference (p=0.5), mean of number of embryos transferred was 2.9± 0.995 in conscious group and 2.78± 0.706 in GA group with no significant difference (p=0.5), and grade of embryo transferred mean level was 1.67± 0.685 in conscious group and 1.52± 0.601 in GA group with no sig-nificant difference (p=0.3). Pregnancy in conscious group happened in 13 (37.1%) and 12 (34.3%) of patients in GA group.Conclusion: Conscious anesthesia remifentanil with had better reproductive outcome on fertilization rate cleavage and grade 1 embryo rate with significant higher pregnancy rate than general anesthesia with propofol.

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Section: Discussionmentioning

confidence: 64%

Effect of conscious anesthesia with remifentanil versus general anesthesia with propofol on embryo quality and pregnancy rate in ICSI

2022

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“…In (Oliveira Júnior, et al [6] ; Bümen, et al [9] ; Matsota, et al [12] ). Also, remifentanil has the advantage of significantly higher total oocyte number when it was given in continuous intravenous infusion and compare with local anesthesia (Milanini, et al [24] ) or given in GA (remifentanil with either propofol or isoflurane) and compare with sedation (midazolam, diazepam, or propofol) (Hammadeh, et al [25] ).…”

Section: Discussionmentioning

confidence: 99%

“…[4] ). The process is very painful and stressful as the pain is caused by the passage of the needle through the vaginal wall and by the manipulation of the ovary mechanically (Kwan, et al [5] ; Oliveira Júnior, et al [6] ;…”

Section: Introductionmentioning

confidence: 99%

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Effect of drugs used in general anesthesia on oocyte and embryo quality in Iraqi infertile females undergoing intracytoplasmic sperm injection

Mohsin

Jwad

Reshan

2020

IJEIR

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Various types of anesthetic techniques were described for oocyte recovery. Different anesthetic agents have been used with different effects on oocyte quality and embryonic development and studies on the potential toxicity of general anesthesia ended up with conflicting results. Many experiments as well as human studies documented the existence of anesthetic agents in the follicular fluid (FF) with possible adverse effects on the oocyte quality and subsequent embryo development. Ketamine and remifentanil were used for the studied groups to compare oocytes and embryos characteristic of infertile women during oocytes retrieval under general anesthesia: one group receiving ketamine, midazolam, and propofol and the other group receiving remifentanil, midazolam and propofol. 60 infertile females were undergoing intracytoplasmic sperm injection categorized in two groups, group I received midazolam, remifentanil and propofol; whereas, group II received midazolam, ketamine and propofol. There was highly significant difference in mean abnormal oocyte between ketamine and remifentanil groups. Grade III embryos were significantly limited to ketamine group. FF ketamine and remifentanil were not significantly correlated to any of oocyte characteristics or embryo characteristics. Anesthetic agents, ketamine and remifentanil, were detected in the FF of infertile women and within recommended doses. Ketamine resulted in adverse effects on oocyte and embryo quality in comparison with remifentanil represented by greater percentage of abnormal oocytes and that bad quality embryos were limited to ketamine group.

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“…After 30 min in the PACU, we evaluated the satisfaction scores of the endoscopists and patients using a visual analog scale (VAS, 0 = dissatisfaction, and 10 = full satisfaction). Patients were considered eligible for discharge with a score ≥ 9, according to the modified Aldrete–Kroulik index [7].…”

Section: Methodsmentioning

confidence: 99%

Doxapram alleviates low SpO2 induced by the combination of propofol and fentanyl during painless gastrointestinal endoscopy

Lian

Wang

et al. 2019

BMC Anesthesiol

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BackgroundPainless gastrointestinal endoscopy under intravenous propofol anesthesia is widely applied in the clinical scenario. Despite the good sedation and elimination of anxiety that propofol provides, low SpO2 may also result. Doxapram is a respiratory stimulant with a short half-life. The primary aim of this study was to investigate the effects of doxapram on alleviating low SpO2 induced by the combination of propofol and fentanyl during painless gastrointestinal endoscopy.MethodsIn this prospective study, patients scheduled for painless gastrointestinal endoscopy were randomly assigned to group D or S with 55 patients per group. Initially, both groups received a combination of propofol and fentanyl. Patients in group D received 50 mg doxapram after propofol injection, while patients in group S received an equal volume of saline. Vital signs of the patients, propofol dose, examination duration, and incidences of low SpO2 were recorded.ResultsThere were no statistical differences in propofol consumption and examination duration between the two groups. Twenty-six patients in group S experienced low SpO2 versus 10 in group D (P = 0.001). Nineteen patients in group S underwent oxygenation with a face mask in contrast to 8 in group D (P = 0.015). Eighteen patients in group S were treated with jaw lifting compared to 5 in group D (P = 0.002). Four patients in group S underwent assisted respiration compared to 2 in group D (without statistical difference). The average oxygen saturation in group S was significantly lower than that in group D at 1, 2 and 3 min after propofol injection (P < 0.001, P = 0.001 and P = 0.020, respectively). There were no statistical differences in oxygen saturation at other time points. There were no statistical differences in MAP and HR (except for the time point of 1 min after the induction) between the two groups.ConclusionsLow dose of doxapram can effectively alleviate low SpO2 in painless gastrointestinal endoscopy with intravenous propofol, without affecting propofol consumption, examination duration, MAP, or HR.Trail registrationThe study was approved by the Institutional Ethics Committee of Clinical and New Technology of Wuxi People’s Hospital on 20th July, 2018 (KYLLH2018029) and registered in the Chinese Clinical Trial Register on 16th August, 2018 (ChiCTR1800017832).

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Randomized double-blind clinical trial comparing two anesthetic techniques for ultrasound-guided transvaginal follicular puncture

Cited by 9 publications

References 9 publications

Effect of conscious anesthesia with remifentanil versus general anesthesia with propofol on embryo quality and pregnancy rate in ICSI

Effect of conscious anesthesia with remifentanil versus general anesthesia with propofol on embryo quality and pregnancy rate in ICSI

Effect of drugs used in general anesthesia on oocyte and embryo quality in Iraqi infertile females undergoing intracytoplasmic sperm injection

Doxapram alleviates low SpO2 induced by the combination of propofol and fentanyl during painless gastrointestinal endoscopy

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