TOTAL INTRAVENOUS ANESTHESIA WITH SPONTANEOUS BREATHING FOR TRANSVAGINAL OOCYTE RETRIEVAL

Objective: The aim of this study was to compare the adequacy of spontaneous breathing and assisted ventilation with laryngeal mask airway (LMA) during total intravenous anesthesia for transvaginal oocyte retrieval.Methods: One hundred patients, undergoing transvaginal oocyte retrieval under propofol - alfentanil anesthesia were randomly assigned into two groups. Anesthesia was induced with 2 mg.kg-1 propofol and 10 pg.kg-1 alfentanil i.v. in all patients . The ventilation was assisted with LMA in group I and was spontaneous in group II. One mg.kg-1 propofol and 5 pg.kg-1 alfentanil i.v. were administered when needed. Systolic and diastolic blood pressure, heart rate, oxygen saturation (Sp02) and end-tidal C02 pressure (ETC02), total drug doses administered, side effects and Aldrete recovery score were recorded.Results: Blood pressure and heart rate decreased significantly in all patients after induction (p<0.001). Sp02 increased and ETC02 decreased significantly at the 5th min in group I. Sp02 in group I and ETC02 in group II was found significantly higher (p<0.001) but remained within normal range during the operation. There were no differences in the time to achieve an Aldrete recovery score of 10 and the incidence of side effects.Conclusion: We concluded that propofol- alfentanil anesthesia with spontaneous breathingis an effective and safe anesthetic technique for transvaginal oocyte retrieval.Key Words: Intravenous anaesthetics,Propofol, Alfentanil, Transvaginal oocyte retrieval

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  • Tontisirin O, Rojanasakul A, Srisombut C et al. Propofol anesthesia for transvaginal ultrasound guided oocyte retrieval. J Med Assoc Thai 1996; 79: 618-623.
  • Huang IIW, lluang PJ, Rung FT, et al. Effects
  • of induction anesthetic agents on outcome of assisted reproductive technology: a
  • comparison of propofol and thiopental sodium. Changgeng Yi Xue Za Zhi 2000; 23: 513-519.
  • Ben-Shlomo I, Moskowich R, Golan J, et al. The effect of propofol anesthesia on oocyte fertilization and early embryo quality. Hum Reprod 2000; 15: 2197-2199.
  • Casati A, Valentini G, Zangrillo A, et al.
  • Anesthesia for ultrasound guided oocyte retrieval: midazolam-remifentanil versus
  • propofol-fentanil regimens. EurJ Anaesthesiol 1999; 16: 773-778.
  • Ben-Shlomo I, Amodai I, Levran D, et al. Midazolam-fentanyl sedation in conjunction with local anesthesia during oocyte retrieval for in vitro fertilization. J Assist Reprod Genet 1992; 9: 83-85.
  • Ramsewak 55, Rumar A, Welsby R, et al. Is analgesia required for transvaginal single follicle aspiration in in vitro fertilization? A double-blind study. J In Vitro Fert Embryo Transf 1990; 7: 103-106.
  • flaito Y, Tamai S, Fukata J, et al. Comparison of endocrinological stress response associated with transvaginal ultrasound guided oocyte pick-up under halotane anesthesia and neurolept anesthesia. Can J Anaesth 1989; 36: 633-636.
  • Commings DJ, Whitter H, Okoli UC, Ewart M. Postintubation uvular necrosis. Anaesthesia 1994; 49: 457-458.
  • Teichner RL. Lingual nerve injury: a
  • complication of orotracheal intubation. Br J Anaesth 1971; 43: 413.
  • Cavo JWJ. True vocal cord paralysis following intubation. Laryngoscope 1985; 95: 1352- 1359.
  • Benjamin B. Prolonged intubation injuries of
  • the larynx: endoscopic diagnosis,
  • classification and treatment. Ann Otol Rhinol Laryngoi 1993; 160 (suppl): 1-15.
  • Dingley J, Wareham R. A comparative study of the incidence of sore throat with the laryngeal mask airway. Anaesthesia 1994; 49: 251-254.
  • Brimacombe J, Beery A. Laryngeal mask airway cuff pressure and position during anesthesia lasting one to two hours. Can J Anaesth 1994; 41: 589-593.
  • Burgard G, Mollhoff T, Prien T. The effect of laryngeal mask cuff pressure on postoperative sore throat incidence. J Clin Anesth 1996; 8: 198-210.
  • Shresta BM, Basnyat HB. Experience with the laryngeal mask airway in Hepal. Today's Anaesthesist 1993; 8: 133-134.
  • Lloyd JFR, Hegap A. Recurrent laryngeal nerve palsy after laryngeal mask insertion. Anaesthesia 1996; 51: 171-1 72.
  • I 7. Ring C, Street MR. Twelfth cranial nerve palsy following use of laryngeal mask airway. Anaesthesia 1994; 49: 786-787.