Matsota Paraskevi, Sidiropoulou Tatiana, Vrantza Tereza, Boutsikou Maria, Midvighi Elena, Siristatidis Charalampos
Second Department of Anesthesiology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12642 Athens, Greece.
Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12642 Athens, Greece.
J Clin Med. 2021 Mar 1;10(5):963. doi: 10.3390/jcm10050963.
(1) Background: There has been various reports on the potential impact of anesthetic agents used during oocyte retrieval (OR) on the impairment of the capacity of the oocyte for fertilization and subsequent embryo quality; results have been conflicting; (2) Methods: The effects of two different sedation protocols during OR in two groups of patients undergoing In Vitro Fertilization/Intra-Cytoplasmic Sperm Injection IVF/ICSI, were compared on propofol consumption and on in vitro fertilization (IVF)/ICSI success. The study group received dexmedetomidine and fentanyl, while the control remifentanil and midazolam. In a prospective cohort study, we encompassed 72 cycles/patients. The administered dose of propofol per patient and fertilization rates were the primary outcomes, while anesthesiological parameters and IVF/ICSI outcomes were the secondary endpoints; (3) Results: We found a significant increase in propofol consumption in the study compared to the control group (77.0 ± 10.6 mg vs. 12.1 ± 6.1; < 0.001), but fertilization rates were similar ( = 0.469). From the secondary anesthesiological outcomes, the post anesthesia discharge scores were better in the control group (15.0 (13.5 min) vs. 5.0 (10.0 min), = 0.028). From the IVF/ICSI secondary outcome parameters, we found a higher quality of embryos on day three in the study compared to the control group ( = 0.040). The comparison of the other secondary outcomes yielded non-significant differences; (4) Conclusions: The use of dexmedetomidine, as an alternative agent during OR, was associated with higher propofol consumption as a rescue dose compared to remifentanil but was linked with similar fertilization rates and higher quality of embryos produced.
(1) 背景：关于取卵（OR）过程中使用的麻醉剂对卵母细胞受精能力及后续胚胎质量损害的潜在影响，已有各种报道；结果相互矛盾。(2) 方法：比较两组接受体外受精/卵胞浆内单精子注射（IVF/ICSI）的患者在取卵过程中两种不同镇静方案对丙泊酚用量及体外受精（IVF）/ICSI成功率的影响。研究组接受右美托咪定和芬太尼，而对照组接受瑞芬太尼和咪达唑仑。在一项前瞻性队列研究中，我们纳入了72个周期/患者。每位患者的丙泊酚给药剂量和受精率为主要结局，而麻醉学参数和IVF/ICSI结局为次要终点。(3) 结果：我们发现研究组的丙泊酚用量相较于对照组显著增加（77.0±10.6毫克对12.1±6.1毫克；<0.001），但受精率相似（=0.469）。从次要麻醉学结局来看，对照组的麻醉后出院评分更好（15.0（13.5分钟）对5.0（10.0分钟），=0.028）。从IVF/ICSI次要结局参数来看，我们发现研究组第三天的胚胎质量相较于对照组更高（=0.040）。其他次要结局的比较未产生显著差异。(4) 结论：与瑞芬太尼相比，在取卵过程中使用右美托咪定作为替代药物，作为抢救剂量时丙泊酚用量更高，但受精率相似且所产生的胚胎质量更高。
