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Human Reproduction, Vol. 14, No. 7, 1757-1759, July 1999
© 1999 European Society of Human Reproduction and Embryology

Midazolam/ketamine sedative combination compared with fentanyl/propofol/isoflurane anaesthesia for oocyte retrieval

Izhar Ben-Shlomo1,3, Roland Moskovich2, Yeshayahu Katz2,3,4 and Eliezer Shalev1,3

1 Department of Obstetrics and Gynecology, 2 Department of Anesthesiology, HaEmek Medical Centre, Afula, and 3 Rappaport School of Medicine, Technion–Israel Institute of Technology, Haifa, Israel

Assisted reproduction may be associated with repeated occasions of surgical intervention. Propofol, which is frequently used for induction of anaesthesia in such procedures, has been suspected of damaging oocytes. We compared in a randomized prospective design the use of general anaesthesia with fentanyl 0.017 mg/kg, propofol 2.5 mg/kg and isoflurane to that of sedation with midazolam 0.06 mg/kg and ketamine 0.75 mg/kg for transvaginal oocyte retrieval in 50 patients with no premedication. Overall, patient satisfaction was not different between the groups. Sedated patients were more arousable than anaesthetized patients during the procedure and experienced less postoperative abdominal pain at 30 min. Despite some movement in response to pain, oocyte retrieval was conveniently feasible in all sedated patients, of which none required a switch to general anaesthesia. A comparable number of oocytes was retrieved per cycle, 10.8 (±7.8) versus 9.6 (±10.9) with sedation and anaesthesia respectively. No patient recalled any pain sensation during the procedure. The rate of embryo transfers and pregnancies were not different between the two groups. We conclude that the sedative combination of midazolam and ketamine for oocyte retrieval may serve as an alternative for general anaesthesia.

Key words: assisted reproduction/general anaesthesia/oocyte retrieval/sedation

4 To whom correspondence should be addressed at: Department of Anaesthesiology, HaEmek Medical Center, Afula 18101, Israel


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