Patient Experience with Conscious Sedation as a Method of Pain Relief for Transvaginal Oocyte Retrieval: A Cross Sectional Study

Himanshu Singhal, Prasanna S Premkumar, Achamma Chandy, Aleyamma T Kunjummen, Mohan S Kamath, Himanshu Singhal, Prasanna S Premkumar, Achamma Chandy, Aleyamma T Kunjummen, Mohan S Kamath

Abstract

Aim: The aim of the study was to measure patient's satisfaction level and acceptance of conscious sedation as a method of pain relief following transvaginal oocyte retrieval (TVOR) during assisted reproduction technology treatment. We also evaluated the factors that may influence the efficacy of conscious sedation method.

Setting and design: A prospective cross-sectional study.

Materials and methods: Prospective study was conducted from October 2015 to January 2016 at a university-level hospital and 100 women were recruited. Variables for analysis included woman age, duration of procedure, number of oocytes retrieved, and transmyometrial passage of the needle. Pain assessment was done by visual analog scale (VAS). Medical complications, and patient satisfaction score [Likert's score and client satisfaction questionnaire (CSQ)] were recorded.

Results: There was a moderate positive correlation between age and pain score on day 1 post-procedure. When the duration of procedure was >12 min, immediate post-procedure pain score was significantly higher compared to those whose procedure where duration was <12 min. There was no correlation between pain score and the number of oocytes retrieved (≤5, 6-15, and ≥16) and transmyometrial passage of needle. The VAS 10-point score immediately post-procedure, after 6 and 24 h post-procedure, and on day of embryo transfer was 2.83 (±1.67), 0.78 (±1.04), 0.39 (±1.09), and 0.14 (±0.58), respectively. The Likert's score was 3.65 (±0.82) and mean CSQ was 27.04 (±3.01). Majority of the women (86%) preferred the same pain relief method for future analgesia. There were no major complications.

Conclusion: Conscious sedation was associated with high satisfaction level and acceptance rate among patients undergoing TVOR.

Keywords: Conscious sedation; pain relief; transvaginal oocyte retrieval.

Conflict of interest statement

There are no conflicts of interest.

References

    1. Tanbo T, Henriksen T, Magnus O, Abyholm T. Oocyte retrieval in an IVF program. A comparison of laparoscopic and vaginal ultrasound-guided follicular puncture. Acta Obstet Gynecol Scand. 1988;67:243–6.
    1. Gleicher N, Friberg J, Fullan N, Giglia RV, Mayden K, Kesky T, et al. Egg retrieval for in vitro fertilisation by sonographically controlled vaginal culdocentesis. Lancet. 1983;2:508–9.
    1. Wikland M, Enk L, Hamberger L. Transvesical and transvaginal approaches for the aspiration of follicles by use of ultrasound. Ann N Y Acad Sci. 1985;442:182–94.
    1. el Hussein E, Balen AH, Tan SL. A prospective study comparing the outcome of oocytes retrieved in the aspirate with those retrieved in the flush during transvaginal ultrasound directed oocyte recovery for in-vitro fertilization. Br J Obstet Gynaecol. 1992;99:841–4.
    1. Kwan I, Bhattacharya S, Knox F, McNeil A. Pain relief for women undergoing oocyte retrieval for assisted reproduction. Cochrane Database Syst Rev. 2013:CD004829.
    1. Elkington NM, Kehoe J, Acharya U. Intravenous sedation in assisted conception units: a UK survey. Hum Fertil (Camb) 2003;6:74–6.
    1. Lefebvre G, Vauthier D, Seebacher J, Henry M, Thormann F, Darbois Y. In vitro fertilization: a comparative study of cleavage rates under epidural and general anesthesia—interest for gamete intrafallopian transfer. J In Vitro Fert Embryo Transf. 1988;5:305–6.
    1. Hayes MF, Sacco AG, Savoy-Moore RT, Magyar DM, Endler GC, Moghissi KS. Effect of general anesthesia on fertilization and cleavage of human oocytes in vitro. Fertil Steril. 1987;48:975–81.
    1. Gonen O, Shulman A, Ghetler Y, Shapiro A, Judeiken R, Beyth Y, et al. The impact of different types of anesthesia on in vitro fertilization embryo transfer treatment outcome. J Assist Reprod Genet. 1995;12:678–82.
    1. Trout SW, Vallerand AH, Kemmann E. Conscious sedation for in vitro fertilization. Fertil Steril. 1998;69:799–808.
    1. Ditkoff EC, Plumb J, Selick A, Sauer MV. Anesthesia practices in the United States common to in vitro fertilization (IVF) centers. J Assist Reprod Genet. 1997;14:145–7.
    1. Fiebai PO, Ogunmokun AA, Ajayi RA. Experience with conscious sedation for oocyte retrieval in Nigeria. Afr J Reprod Health. 2008;12:30–4.
    1. Cerne A, Bergh C, Borg K, Ek I, Gejervall AL, Hillensjö T, et al. Pre-ovarian block versus paracervical block for oocyte retrieval. Hum Reprod. 2006;219110:2916–21.
    1. Kuhlmann T, Dantlgraber M, Reips UD. Investigating measurement equivalence of visual analogue scales and Likert-type scales in Internet-based personality questionnaires. Behav Res Methods 2017. Article in press.
    1. Matsubara C, Green J, Astorga LT, Daya EL, Jervoso HC, Gonzaga EM, et al. Reliability tests and validation tests of the client satisfaction questionnaire (CSQ-8) as an index of satisfaction with childbirth-related care among Filipino women. BMC Pregnancy Childbirth. 2013;13:235.
    1. Ben-Shlomo I, Moskovich R, Katz Y, Shalev E. Midazolam/Ketamine sedative combination compared with fentanyl/propofol/isoflurane anaesthesia for oocyte retrieval. Hum Reprod. 1999;14:1757–9.
    1. Bokhari A, Pollard BJ. Anaesthesia for assisted conception: a survey of UK practice. Eur J Anaesthesiol. 1999;16:225–30.

Source: PubMed

3
Abonnere