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Epidural anesthesia in an in vitro fertilization and embryo transfer program.

作者信息

Botta G, D'Angelo A, D'Ari G, Merlino G, Chapman M, Grudzinskas G

机构信息

Ecocenter and Fertility Center, Clinica C. G. Ruesch, Napoli, Italy.

出版信息

J Assist Reprod Genet. 1995 Mar;12(3):187-90. doi: 10.1007/BF02211796.

DOI:10.1007/BF02211796
PMID:8520183
Abstract

OBJECTIVES

To investigate the potential advantages of epidural anesthesia in an in vitro fertilization and embryo transfer program.

STUDY DESIGN

Between January 1991 and December 1992, 148 infertile patients underwent transvaginal ultrasound guided oocyte retrieval. A total of 44 patients (group A) had 50 retrievals under epidural anesthesia, and 104 patients (group B, control group) 112 retrievals under intravenous sedation (propofol) with mask-assisted ventilation (nitrous oxide).

RESULTS

In group A satisfactory anesthesia was achieved in 49 of the 50 cases (98%); one patient required additional intravenous administration of propofol owing to extreme anxiety. No complications were observed. Adversely, in group B nausea was observed in 16 cases (14%) and nausea and vomiting in 7 cases (6%). In group A the fertilization, cleavage and pregnancy rates were 67.2%, 92% and 20% respectively, while in group B the rates were 69.3%, 93% and 19.6% respectively; the differences are not statistically significant.

CONCLUSIONS

Epidural anesthesia is an effective method for transvaginal oocyte retrieval but does not improve the treatment outcome as compared to an intravenous sedation with mask-assisted ventilation using propofol and nitrous oxide.

摘要

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Non-Operating Room Anesthesia: Patient Selection and Special Considerations.非手术室麻醉:患者选择与特殊考量
Local Reg Anesth. 2020 Jan 8;13:1-9. doi: 10.2147/LRA.S181458. eCollection 2020.
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Anesthesia Related Toxic Effects on In Vitro Fertilization Outcome: Burden of Proof.麻醉相关的体外受精结局毒性效应:举证责任。

本文引用的文献

1
Follicular fluid concentrations of thiopental and thiamylal during laparoscopy for oocyte retrieval.腹腔镜取卵术中卵泡液中硫喷妥钠和硫戊巴比妥的浓度。
Fertil Steril. 1987 Nov;48(5):828-33. doi: 10.1016/s0015-0282(16)59539-9.
2
Isofluorane inhibits early mouse embryo development in vitro.异氟烷在体外抑制小鼠早期胚胎发育。
Fertil Steril. 1988 Jan;49(1):171-3.
3
In vitro fertilization: a comparative study of cleavage rates under epidural and general anesthesia--interest for gamete intrafallopian transfer.体外受精:硬膜外麻醉与全身麻醉下卵裂率的比较研究——对配子输卵管内移植的意义
Biomed Res Int. 2015;2015:475362. doi: 10.1155/2015/475362. Epub 2015 Jun 16.
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Anaesthesia for in vitro fertilisation.体外受精的麻醉
Indian J Anaesth. 2009 Aug;53(4):408-13.
J In Vitro Fert Embryo Transf. 1988 Oct;5(5):305-6. doi: 10.1007/BF01132185.
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Effect of general anesthesia on fertilization and cleavage of human oocytes in vitro.全身麻醉对人卵母细胞体外受精及卵裂的影响。
Fertil Steril. 1987 Dec;48(6):975-81. doi: 10.1016/s0015-0282(16)59594-6.
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A paired analysis of in vitro fertilization and cleavage rates of first- versus last-recovered preovulatory human oocytes exposed to varying intervals of 100% CO2 pneumoperitoneum and general anesthesia.
Fertil Steril. 1987 Dec;48(6):969-74. doi: 10.1016/s0015-0282(16)59593-4.
6
Modifying effects of epidural analgesia or general anesthesia on the stress hormone response to laparoscopy for in vitro fertilization.硬膜外镇痛或全身麻醉对体外受精腹腔镜手术应激激素反应的调节作用。
J In Vitro Fert Embryo Transf. 1987 Feb;4(1):23-9. doi: 10.1007/BF01555431.
7
[Use of nitrous oxide in general anesthesia for oocyte retrieval].[氧化亚氮在卵母细胞采集全身麻醉中的应用]
Ann Fr Anesth Reanim. 1989;8 Suppl:R147.
8
Effects of nitrous oxide on preimplantation mouse embryo cleavage and development.氧化亚氮对植入前小鼠胚胎分裂和发育的影响。
Biol Reprod. 1990 Jul;43(1):158-61. doi: 10.1095/biolreprod43.1.158.