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Anesthesia and Analgesia for Women Undergoing Oocyte Retrieval

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Pick Up and Oocyte Management

Abstract

Attempts at producing a state of general anesthesia can be traced throughout history in the writings of the ancient Sumerians, Babylonians, Assyrians, Egyptians, Greeks, Romans, Indians, and Chinese. The Renaissance made significant advances in anatomy and surgical techniques, despite all this progress only with the discovery and introduction of general anesthesia in late eighteenth century permitted development of modern surgery.

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Notes

  1. 1.

    Monitored Anesthesia Care (“MAC”) does not describe the continuum of depth of sedation, rather it describes “a specific anesthesia service in which an anesthesiologist has been requested to participate in the care of a patient undergoing a diagnostic or therapeutic procedure.”

  2. 2.

    Reflex withdrawal from a painful stimulus is NOT considered a purposeful response.

  3. 3.

    Rescue of a patient from a deeper level of sedation than intended is an intervention by a practitioner proficient in airway management and advanced life support. The qualified practitioner corrects adverse physiologic consequences of the deeper-than-intended level of sedation (such as hypoventilation, hypoxia, and hypotension) and returns the patient to the originally intended level of sedation. It is not appropriate to continue the procedure at an unintended level of sedation.

References

  1. Ramsay MAE. John Snow, MD: anaesthetist to the Queen of England and pioneer epidemiologist. Proc (Bayl Univ Med Cent). 2006;19(1):24–8.

    Article  Google Scholar 

  2. Steptoe PC, Edwards RG. Birth after the reimplantation of human embryo. Lancet. 1978;12:2–366.

    Google Scholar 

  3. Yentis S, May A, Malhotra S. Analgesia, anaesthesia and pregnancy. A practical guide. Cambridge: Cambridge University Press; 2001.

    Google Scholar 

  4. Baldini D, Savoia MV, Sciancalepore AG, Malvasi A, Vizziello D, Beck R, Vizziello G. High progesterone levels on the day of HCG administration do not affect the embryo quality and the reproductive outcomes of frozen embryo transfers. Clin Ter. 2018;169(3):e91–5. https://doi.org/10.7417/CT.2018.2060.

    Article  PubMed  CAS  Google Scholar 

  5. Gejervall AL, Lundin K, Stener-Victorin E, Bergh C. Effect of alfentanil dosage during oocyte retrieval on fertilization and embryo quality. Eur J Obstet Gynecol Reprod Biol. 2010;150(1):66–71. https://doi.org/10.1016/j.ejogrb.2010.01.007. Epub 2010 Mar 11.

    Article  PubMed  CAS  Google Scholar 

  6. Kuczkowski KM, Reisner LS, Benumof JL. Airway problems and new solutions for the obstetric patient. J Clin Anesth. 2003;15(7):552–63.

    Article  Google Scholar 

  7. Malvasi A, Tinelli A, Di Renzo GC. Management and therapy of late pregnancy complications. Champaign: Springer; 2017.

    Book  Google Scholar 

  8. Practice Guidelines for Obstetric Anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016;124(2):270–300. https://doi.org/10.1097/ALN.0000000000000935.

  9. Davies JM, Posner KL, Lee LA, Cheney FW, Domino KB. Liability associated with obstetric anesthesia: a closed claims analysis. Anesthesiology. 2009;110(1):131–9. https://doi.org/10.1097/ALN.0b013e318190e16a.

    Article  PubMed  Google Scholar 

  10. Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, Harper A, Hulbert D, Lucas S, McClure J, Millward-Sadler H, Neilson J, Nelson-Piercy C, Norman J, O’Herlihy C, Oates M, Shakespeare J, de Swiet M, Williamson C, Beale V, Knight M, Lennox C, Miller A, Parmar D, Rogers J, Springett A. Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006–2008. The eighth report of the confidential enquiries into maternal deaths in the United Kingdom. BJOG. 2011;118(Suppl 1):1–203. https://doi.org/10.1111/j.1471-0528.2010.02847.x.

    Article  Google Scholar 

  11. D’Angelo R, Smiley RM, Riley ET, Segal S. Serious complications related to obstetric anesthesia: the serious complication repository project of the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2014;120(6):1505–12. https://doi.org/10.1097/ALN.0000000000000253.

    Article  PubMed  CAS  Google Scholar 

  12. Irlbeck T, Zwißler B, Bauer A. ASA classification: transition in the course of time and depiction in the literature. [Article in German]. Anaesthesist. 2017;66(1):5–10. https://doi.org/10.1007/s00101-016-0246-4.

    Article  PubMed  CAS  Google Scholar 

  13. Soussis I, Boyd O, Paraschos T, Duffy S, Bower S, Troughton P, et al. Follicular fluid levels of midazolam, fentanyl, and alfentanil during transvaginal oocyte retrieval. Fertil Steril. 1995;64(5):1003–7.

    Article  CAS  Google Scholar 

  14. Guasch E, Ardoy M, Cuadrado C, González Gancedo P, González A, Gilsanz F. Comparison of 4 anesthetic techniques for in vitro fertilization. [Article in Spanish]. Rev Esp Anestesiol Reanim. 2005;52(1):9–18.

    PubMed  CAS  Google Scholar 

  15. Christiaens F, Janssenswillen C, Van Steirteghem AC, Devroey P, Verborgh C, Camu F. Comparison of assisted reproductive technology performance after oocyte retrieval under general anaesthesia (propofol) versus paracervical local anaesthetic block: a case-controlled study. Hum Reprod. 1998;13(9):2456–60.

    Article  CAS  Google Scholar 

  16. Janssenswillen C, Christiaens F, Camu F, Van Steirteghem A. The effect of propofol on parthenogenetic activation, in vitro fertilization and early development of mouse oocytes. Fertil Steril. 1997;67(4):769–74.

    Article  CAS  Google Scholar 

  17. Hammadeh ME, Wilhelm W, Huppert A, Rosenbaum P, Schmidt W. Effects of general anaesthesia vs. sedation on fertilization, cleavage and pregnancy rates in an IVF program. Arch Gynecol Obstet. 1999;263(1–2):56–9.

    Article  CAS  Google Scholar 

  18. Sterzik K, Nitsch CD, Korda P, Sasse V, Rosenbusch B, Marx T, Traub E. The effect of different anesthetic procedures on hormone levels in women. Studies during an in vitro fertilization-embryo transfer (IVF-ET) program. [Article in German]. Anaesthesist. 1994;43(11):738–42.

    Article  CAS  Google Scholar 

  19. Vricella LK, Louis JM, Mercer BM, Bolden N. Anesthesia complications during scheduled cesarean delivery for morbidly obese women. Am J Obstet Gynecol. 2010;203:276.e1–5. https://doi.org/10.1016/j.ajog.2010.06.022. Epub 2010 Jul 31.

    Article  Google Scholar 

  20. American Society of Anesthesiologists. Continuum of depth of sedation: definition of general anesthesia and levels of sedation/analgesia. Developed by Committee on Quality Management and Departmental Administration. Approved by the ASA House of Delegates on October 13, 1999, and last amended on October 15, 2014.

    Google Scholar 

  21. Somerson SJ, Husted CW, Sicilia MR. Insights into conscious sedation. Am J Nurs. 1995;95(6):26–32.

    PubMed  CAS  Google Scholar 

  22. 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(3):145–7.

    Article  CAS  Google Scholar 

  23. Yamakura T, Sakimura K, Shimoji K, Mishina M. Effects of propofol on various AMPA-, kainate- and NMDA-selective glutamate receptor channels expressed in Xenopus oocytes. Neurosci Lett. 1995;188(3):187–90.

    Article  CAS  Google Scholar 

  24. Cotoia A, Mirabella L, Beck R, Matrella P, Assenzo V, Chazot T, Cinnella G, Liu N, Dambrosio M. Effects of closed-loop intravenous anesthesia guided by Bispectral Index in adult patients on emergence delirium: a randomized controlled study. Minerva Anestesiol. 2018;84(4):437–46. https://doi.org/10.23736/S0375-9393.17.11915-2. Epub 2017 Dec 13.

    Article  PubMed  Google Scholar 

  25. Dershwitz M. Intravenous and inhalation anesthetics. In: William HE, editor. Clinical anesthesia procedures of the Massachusetts General Hospital. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2002. p. 156–8.

    Google Scholar 

  26. Becker DE, Haas DA. Management of complications during moderate and deep sedation: respiratory and cardiovascular considerations. Anesth Prog. 2007;54(2):59–68.

    Article  Google Scholar 

  27. Lehtinen AM, Laatikainen T, Koskimies AI, Hovorka J. Modifying effects of epidural analgesia or general anesthesia on the stress hormone response to laparoscopy for in vitro fertilization. J In Vitro Fert Embryo Transf. 1987;4(1):23–9.

    Article  CAS  Google Scholar 

  28. Gottschalk A, Van Aken H, Zenz M, Standl T. Is anesthesia dangerous? Dtsch Arztebl Int. 2011;108(27):469–74. https://doi.org/10.3238/arztebl.2011.0469. Epub 2011 Jul 8.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Torpy JM, Lynm C, Golub RM. JAMA patient page. Regional anesthesia. JAMA. 2011;306(7):781. https://doi.org/10.1001/jama.306.7.781.

    Article  PubMed  CAS  Google Scholar 

  30. Covino BG. Comparative clinical pharmacology of local anesthetic agents. Anesthesiology. 1971;35(2):158–67.

    Article  CAS  Google Scholar 

  31. Tubben RE, Jain S. Epidural blood patch. StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2018.

    Google Scholar 

  32. Kwak KH. Postdural puncture headache. Korean J Anesthesiol. 2017;70(2):136–43. https://doi.org/10.4097/kjae.2017.70.2.136. Epub 2017 Feb 3.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kuczkowski KM, Beck R. Anesthesia in labor and delivery. In: Di Renzo GC, Berghella V, Malvasi A, editors. Good practice and malpractice in labor and delivery: Edra Publisher; 2019. p. 379–92.

    Google Scholar 

  34. de Santiago J, Santos-Yglesias J, Giron J, Montes de Oca F, Jimenez A, Diaz P. Low-dose 3 mg levobupivacaine plus 10 microg fentanyl selective spinal anesthesia for gynecological outpatient laparoscopy. Anesth Analg. 2009;109(5):1456–61. https://doi.org/10.1213/ANE.0b013e3181ba792e.

    Article  PubMed  CAS  Google Scholar 

  35. Coppejans HC, Vercauteren MP. Low-dose combined spinal-epidural anesthesia for cesarean delivery: a comparison of three plain local anesthetics. Acta Anaesthesiol Belg. 2006;57(1):39–43.

    PubMed  CAS  Google Scholar 

  36. Gebhardt V, Kiefer K, Bussen D, Weiss C, Schmittner MD. Retrospective analysis of mepivacaine, prilocaine and chloroprocaine for low-dose spinal anaesthesia in outpatient perianal procedures. Int J Colorectal Dis. 2018;33(10):1469–77. https://doi.org/10.1007/s00384-018-3085-8.

    Article  PubMed  Google Scholar 

  37. Kogosowski A, Lessing JB, Amit A, Rudick V, Peyser MR, David MP. Epidural block: a preferred method of anesthesia for ultrasonically guided oocyte retrieval. Fertil Steril. 1987;47(1):166–8.

    Article  CAS  Google Scholar 

  38. Palkar NV, Boudreaux RC, Mankad AV. Accidental total spinal block: a complication of an epidural test dose. Can J Anaesth. 1992;39(10):1058–60.

    Article  CAS  Google Scholar 

  39. D’Ambrosio A, Cotoia A, Beck R, Salatto P, Zibar L, Cinnella G. Impedance cardiography as tool for continuous hemodynamic monitoring during cesarean section: randomized, prospective double blind study. BMC Anesthesiol. 2018;18(1):32. https://doi.org/10.1186/s12871-018-0498-4.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  40. Vlahos NF, Giannakikou I, Vlachos A, Vitoratos N. Analgesia and anesthesia for assisted reproductive technologies. Int J Gynaecol Obstet. 2009;105(3):201–5. https://doi.org/10.1016/j.ijgo.2009.01.017. Epub 2009 Feb 26.

    Article  PubMed  Google Scholar 

  41. Vela Vásquez RS, Peláez Romero R. Aspirin and spinal haematoma after neuraxial anaesthesia: myth or reality? Br J Anaesth. 2015;115(5):688–98. https://doi.org/10.1093/bja/aev348.

    Article  PubMed  CAS  Google Scholar 

  42. Gogarten W. The influence of new antithrombotic drugs on regional anesthesia. Curr Opin Anaesthesiol. 2006;19(5):545–50.

    Article  Google Scholar 

  43. Huang J, McKenna N, Babins N. Utility of thromboelastography during neuraxial blockade in the parturient with thrombocytopenia. AANA J. 2014;82(2):127–30.

    PubMed  Google Scholar 

  44. Lee LO, Bateman BT, Kheterpal S, Klumpner TT, Housey M, Aziz MF, Hand KW, MacEachern M, Goodier CG, Bernstein J, Bauer ME, Multicenter Perioperative Outcomes Group Investigators. Risk of epidural hematoma after neuraxial techniques in thrombocytopenic parturients: a report from the multicenter perioperative outcomes group. Anesthesiology. 2017;126(6):1053–63. https://doi.org/10.1097/ALN.0000000000001630.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Pugliese PL, Cinnella G, Raimondo P, De Capraris A, Salatto P, Sforza D, Menga R, D’Ambrosio A, Fede RN, D’Onofrio C, Consoletti L, Malvasi A, Brizzi A, Dambrosio M. Implementation of epidural analgesia for labor: is the standard of effective analgesia reachable in all women? An audit of two years. Eur Rev Med Pharmacol Sci. 2013;17(9):1262–8.

    PubMed  CAS  Google Scholar 

  46. Kuczkowski KM, Beck R. Labor analgesia. In: Di Renzo GC, Berghella V, Malvasi A, editors. Good practice and malpractice in labor and delivery: Edra Publisher; 2019. p. 361–77.

    Google Scholar 

  47. Kumar K, Singh SI. Neuraxial opioid-induced pruritus: an update. J Anaesthesiol Clin Pharmacol. 2013;29(3):303–7. https://doi.org/10.4103/0970-9185.117045.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Wu Z, Kong M, Wang N, Finlayson RJ, Tran QH. Intravenous butorphanol administration reduces intrathecal morphine-induced pruritus after cesarean delivery: a randomized, double-blind, placebo-controlled study. J Anesth. 2012;26(5):752–7. https://doi.org/10.1007/s00540-012-1421-7. Epub 2012 Jun 7.

    Article  PubMed  Google Scholar 

  49. Farag E, Mounir-Soliman L. Brown’s regional anesthesia review. 1st ed. Elsevier—Health Sciences Division; Published Date: 28th May 2016.

    Google Scholar 

  50. Faccenda KA, Finucane BT. Complications of regional anaesthesia. Incidence and prevention. Drug Saf. 2001;24(6):413–42.

    Article  CAS  Google Scholar 

  51. Kwan I, Wang R, Pearce E, Bhattacharya S. Pain relief for women undergoing oocyte retrieval for assisted reproduction. Cochrane Database Syst Rev. 2018;5:CD004829. https://doi.org/10.1002/14651858.CD004829.pub4.

    Article  PubMed  Google Scholar 

  52. Morue HI, Raj-Lawrence S, Saxena S, Delbaere A, Engelman E, Barvais LA. Placebo versus low-dose ketamine infusion in addition to remifentanil target-controlled infusion for conscious sedation during oocyte retrieval: a double-blinded, randomised controlled trial. Eur J Anaesthesiol. 2018;35(9):667–74. https://doi.org/10.1097/EJA.0000000000000826.

    Article  PubMed  CAS  Google Scholar 

  53. Özaltın S, Kumbasar S, Savan K. Evaluation of complications developing during and after transvaginal ultrasound—guided oocyte retrieval. Ginekol Pol. 2018;89(1):1–6. https://doi.org/10.5603/GP.a2018.0001.

    Article  PubMed  Google Scholar 

  54. Rolland L, Perrin J, Villes V, Pellegrin V, Boubli L, Courbiere B. IVF oocyte retrieval: prospective evaluation of the type of anesthesia on live birth rate, pain, and patient satisfaction. J Assist Reprod Genet. 2017;34(11):1523–8. https://doi.org/10.1007/s10815-017-1002-7. Epub 2017 Jul 28.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Zhao H, Feng Y, Jiang Y, Lu Q. Flurbiprofen axetil provides effective analgesia without changing the pregnancy rate in ultrasound-guided transvaginal oocyte retrieval: a double-blind randomized controlled trial. Anesth Analg. 2017;125(4):1269–74. https://doi.org/10.1213/ANE.0000000000002025.

    Article  PubMed  CAS  Google Scholar 

  56. Guillaume A, Schuller-Dufour E, Faitot V, Pirrello O, Rongières C, Ohl J, Nisand I, Bettahar K. Patient’s experience of topical anesthesia by lidocaine vaginal gel for oocyte retrieval. [Article in French]. J Gynecol Obstet Biol Reprod (Paris). 2016;45(8):942–7. https://doi.org/10.1016/j.jgyn.2016.05.006. Epub 2016 Jun 16.

    Article  CAS  Google Scholar 

  57. Goutziomitrou E, Venetis CA, Kolibianakis EM, Bosdou JK, Parlapani A, Grimbizis G, Tarlatzis BC. Propofol versus thiopental sodium as anaesthetic agents for oocyte retrieval: a randomized controlled trial. Reprod Biomed Online. 2015;31(6):752–9. https://doi.org/10.1016/j.rbmo.2015.08.013. Epub 2015 Sep 4.

    Article  PubMed  CAS  Google Scholar 

  58. Lier MC, Douwenga WM, Yilmaz F, Schats R, Hompes PG, Boer C, Mijatovic V. Patient-controlled remifentanil analgesia as alternative for pethidine with midazolam during oocyte retrieval in IVF/ICSI procedures: a randomized controlled trial. Pain Pract. 2015;15(5):487–95. https://doi.org/10.1111/papr.12189. Epub 2014 Apr 12.

    Article  PubMed  Google Scholar 

  59. Piroli A, Marci R, Marinangeli F, Paladini A, Di Emidio G, Giovanni Artini P, Caserta D, Tatone C. Comparison of different anaesthetic methodologies for sedation during in vitro fertilization procedures: effects on patient physiology and oocyte competence. Gynecol Endocrinol. 2012;28(10):796–9. https://doi.org/10.3109/09513590.2012.664193. Epub 2012 Mar 16.

    Article  PubMed  CAS  Google Scholar 

  60. Circeo L, Grow D, Kashikar A, Gibson C. Prospective, observational study of the depth of anesthesia during oocyte retrieval using a total intravenous anesthetic technique and the Bispectral index monitor. Fertil Steril. 2011;96(3):635–7. https://doi.org/10.1016/j.fertnstert.2011.06.010. Epub 2011 Jul 5.

    Article  PubMed  Google Scholar 

  61. Hong JY, Jee YS, Luthardt FW. Comparison of conscious sedation for oocyte retrieval between low-anxiety and high-anxiety patients. J Clin Anesth. 2005;17(7):549–53.

    Article  Google Scholar 

  62. Ng EH, Miao B, Ho PC. Anxiolytic premedication reduces preoperative anxiety and pain during oocyte retrieval. A randomized double-blinded placebo-controlled trial. Hum Reprod. 2002;17(5):1233–8.

    Article  CAS  Google Scholar 

  63. Singhal H, Premkumar PS, Chandy A, Kunjummen AT, Kamath MS. Patient experience with conscious sedation as a method of pain relief for transvaginal oocyte retrieval: a cross sectional study. J Hum Reprod Sci. 2017;10(2):119–23. https://doi.org/10.4103/jhrs.JHRS_113_16.

    Article  PubMed  PubMed Central  Google Scholar 

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Beck, R., Brizzi, A., Cinnella, G., Raimondo, P., Kuczkowski, K.M. (2020). Anesthesia and Analgesia for Women Undergoing Oocyte Retrieval. In: Malvasi, A., Baldini, D. (eds) Pick Up and Oocyte Management. Springer, Cham. https://doi.org/10.1007/978-3-030-28741-2_7

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