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Hum. Reprod. Advance Access published online on July 13, 2006
Human Reproduction, doi:10.1093/humrep/del271
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received March 29, 2006
Revised June 1, 2006
Accepted June 13, 2006

Article

Pre-ovarian block versus paracervical block for oocyte retrieval

Anna Cerne 1 *, Christina Bergh 1, Kia Borg 2, Ingvar Ek 3, Ann-Louise Gejervall 1, Torbjörn Hillensjö 2, Jan I. Olofsson 2, Elisabet Stener-Victorin 4, Margareta Wood 2, and Göran Westlander 1

1 Centre of Reproductive Medicine, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Institution of Clinical Sciences, Sahlgrenska Academy
2 Fertility Centre Scandinavia, Carlanderska Hospital, Goteborg
3 Department of Obstetrics and Gynaecology, Karolinska University Hospital/Huddinge, Stockholm
4 Institution of Neuroscience and Physiology, Sahlgrenska Academy, Goteborg University, Goteborg, Sweden

* To whom correspondence should be addressed.
Anna Cerne, E-mail: anna.m.cerne{at}vgregion.se


  Abstract

BACKGROUND: A pre-ovarian block (POB) technique can be used for pain relief during oocyte retrieval in IVF. The local anaesthetic is deposited in the vaginal wall and between the vaginal wall and the peritoneal surface near the ovary using ultrasound guidance. The aim of this study was to test whether analgesia with POB resulted in improved pain relief compared to paracervical block (PCB). METHODS: A prospective, randomized, multicentre study of POB versus PCB (10 ml of 1% lidocaine each) with 183 patients randomized to POB (n = 96) or PCB (n = 87) was performed. Randomization (via a computer-generated list) was balanced for age, previously completed IVF cycles, degree of anxiety, estimated number of follicles, BMI, premedication and centre. Pain was measured using a visual analogue scale (VAS, 0-100 mm) and given as median values. The primary end-point of this study was overall VAS pain score for both sides during the oocyte retrieval procedure. RESULTS: Overall pain during the entire oocyte retrieval was 22 (POB) and 16 (PCB) (P = 0.42). No differences were found in degree of anxiety, premedication, dose of alfentanil, fertilization rate, number of good-quality embryos or clinical pregnancy rate. CONCLUSIONS: No differences were found in overall pain experienced during the entire oocyte retrieval procedure with POB compared to PCB.

Keywords: oocyte retrieval/pain relief/paracervical block/pre-ovarian block.
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