Conscious sedation with and without paracervical block for transvaginal ultrasonically guided oocyte collection: A comparison of the pain and sedation levels, and postoperative side effects

Background: The quality of intraoperative analgesia with paracervical block (PCB) during egg collection in in-vitro fertilization (IVF) is still unclear. Objective: This study performed to compare the pain levels during egg collection and the subsequent intra and postoperative side effects in patients receiving a conscious sedation with and without paracervical block. Materials and methods: In this prospective, double-blind, and placebo–controlled study, 60 patients undergoing egg collection in their first IVF cycle were randomized to receive conscious sedation in conjunction with paracervical block with 10 ml lidocaine 1.5% (sedation + PCB patients or study group) or with 10 ml normal saline (sedation patients or placebo group). Results: Patients in study group experienced significantly less vaginal (10.40±8.40 mm vs 20.77±4.60 mm respectively; p < 0.0005) and abdominal pain (10.87±5.08 mm vs 35.33±4.27 mm respectively; p < 0.0005) during egg collection, compared with those in placebo group. Propofol requirements was 8.67±2.42 mg in PCB patients vs 25.60±5.29 mg in placebo group (p < 0.0005). Incidence of intraoperative (9.90% vs 50% respectively; p=0.002) and postoperative (3.33% vs 56.66% respectively; p < 0.0005) side effects were significantly less in study patients compared with placebo group. Conclusion: Conscious sedation with PCB appears to be an effective and safe method of providing analgesia and anesthesia for transvaginal retrieval of oocyte.