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在体外受精中,脊髓镇痛相对于全身麻醉在获得成功方面是否具有优势?

Does Spinal Analgesia have Advantage over General Anesthesia for Achieving Success in In-Vitro Fertilization?

作者信息

Aghaamoo Shahrzad, Azmoodeh Azra, Yousefshahi Fardin, Berjis Katayon, Ahmady Farahnazsadat, Qods Kamran, Mirmohammadkhani Majid

机构信息

Department of Gynecology, Semnan University of Medical Sciences, Semnan, Iran.

Department of Reproduction & Infertility, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Oman Med J. 2014 Mar;29(2):97-101. doi: 10.5001/omj.2014.24.

Abstract

OBJECTIVE

Because of high psychological burden and considerable costs of in-vitro fertilization, it is greatly important to identify all factors that may influence its results. In this study, general anesthesia and spinal analgesia used for oocyte retrieval were compared in terms of success in treating infertility among couples who had undergone in-vitro fertilization at an infertility center in Tehran, Iran.

METHODS

This cohort study that was based on analysis of patient records at Mirza Kochak Khan Hospital, Tehran University of Medical Sciences, in 2008-2009. In this study, the status of chemical pregnancy among those who experienced general anesthesia or spinal anesthesia for in-vitro fertilization for the first time were compared, and the possible effects of clinical and laboratory factors using logistic regression models were considered.

RESULTS

Considering the number of transferred embryos, underlying cause of infertility and fetus grade, it was found that practicing spinal anesthesia is significantly related to increased chance of chemical pregnancy (adjusted Odds Ratio=2.07; 95% CI: 1.02,4.20; p=0.043).

CONCLUSION

According to analysis of recorded data in an infertility treatment center in Iran, it is recommended to use spinal anesthesia instead of general anesthesia for oocyte retrieval to achieve successful in-vitro fertilization outcome. This can be studied and investigated further via a proper multicentric study in the country.

摘要

目的

由于体外受精存在较高的心理负担和可观的费用,识别所有可能影响其结果的因素非常重要。在本研究中,对伊朗德黑兰一家不孕不育中心接受体外受精的夫妇中,用于取卵的全身麻醉和脊髓镇痛在治疗不孕不育的成功率方面进行了比较。

方法

这项队列研究基于对德黑兰医科大学米尔扎·科恰克·汗医院2008 - 2009年患者记录的分析。在本研究中,比较了首次接受体外受精时经历全身麻醉或脊髓麻醉者的化学妊娠状态,并使用逻辑回归模型考虑了临床和实验室因素的可能影响。

结果

考虑到移植胚胎数量、不孕不育的潜在原因和胎儿等级,发现实施脊髓麻醉与化学妊娠几率增加显著相关(调整后的优势比 = 2.07;95%置信区间:1.02, 4.20;p = 0.043)。

结论

根据对伊朗一家不孕不育治疗中心记录数据的分析,建议在取卵时使用脊髓麻醉而非全身麻醉,以实现成功的体外受精结果。这可通过该国适当的多中心研究进一步进行研究和调查。

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