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Human Reproduction, Vol. 17, No. 8, 2101-2106, August 2002
© 2002 European Society of Human Reproduction and Embryology

A prospective randomized trial comparing patient-controlled sedation using propofol and alfentanil and physician-administered sedation using diazepam and pethidine during transvaginal ultrasound-guided oocyte retrieval

Ingrid H. Lok1,3, Matthew T.V. Chan2, Daniel L.W. Chan1, L.P. Cheung1, Christopher J. Haines1 and P.M. Yuen1

1 Departments of Obstetrics and Gynaecology and 2 Anaesthesia and Intensive Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR

BACKGROUND: This open label study compared the effectiveness of patient-controlled sedation (PCS), with physician-administered sedation (PAS) during transvaginal ultrasound-guided oocyte retrieval (TUGOR). METHODS: A total of 106 patients was randomized using a computer model to receive either PCS (n = 51) or PAS (n = 55). Intra-operative sedation and co-operation were measured on a 5-point scale while severity of pain, and doctor and patient satisfaction were assessed using a 100 mm visual analogue scale. Number of oocytes retrieved and fertilization, cleavage and clinical pregnancy rates were also recorded. RESULTS: Levels of sedation and co-operation were similar between groups. The pain score was higher in the PCS group during (mean ± SD, 53 ± 23 versus 35 ± 24; P < 0.01) and 2 h after the procedure (29 ± 27 versus 17 ± 22; P < 0.05). Doctors were less satisfied with PCS than PAS (62 ± 25 versus 71 ± 26; P < 0.05) while patients were highly satisfied with both methods (76 ± 23 versus 74 ± 21; not significant). There were no oversedation or peri-operative complications. Fertility outcomes were similar. Patients tended to prefer PCS when given the choice of sedation method. CONCLUSION: Although PCS provides less analgesia then PAS during TUGOR, it is safe, satisfactory and accepted by patients.

Key words: anaesthesia/conscious sedation/IVF/oocyte retrieval/patient-controlled sedation

3 To whom correspondence should be addressed. E-mail: ingridlok{at}cuhk.edu.hk


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