Remifentanil Infusion and Paracervical Block Combination for Transvaginal Ultrasound Guided Oocyte Retrieval

The optimal anesthetic technique for transvaginal ultrasound guided oocyte retrieval (TUGOR) is not known. We presenta case series of patients having TUGOR under intravenous remifentanil infusion and paracervical block (PCB). One hundred fourunpremedicated patients were included in our study. After monitoring heart rate (HR), mean arterial pressure (MAP), peripheraloxygen saturation (SpO2) and end tidal CO2 (ETCO2), a remifentanil infusion of 0.25 µg kg-1 min-1 was started. PCB (10 ml 1%lidocaine) was performed under remifentanil infusion. As soon as the patient felt dizzy, the remifentanil infusion was decreased to0.15 µg kg-1 min-1. Sedation was evaluated according to a 5 - point scale (1: Patient sleeps and cannot be awakened, 2: Patient sleepsand can be awakened with difficulty, 3: Patient sleeps and can be easily awakened, 4: Patient is cooperative, oriented, and tranquil5: Patient is anxious and agitated). Pain intensity was assessed with an 11-point numerical pain rating scale (NPRS) (0 = no painwhile 10 = most severe pain). Patient satisfaction was assessed by asking whether they would prefer the same anesthesia protocolshould they need to undergo a similar procedure in future. Side effects were recorded. ANOVA was used to assess differences intime and P 0.05 was considered significant. HR and MAP decreased significantly from pre-procedure values but they were notclinically significant. Sedation scores remained between 3 and 4 and satisfactory analgesia was achieved in all patients. The mostfrequent side effects were fatigue (43.3%), nausea (34.6%) and pruritus (28.8%). Most of the patients were satisfied with theanesthetic technique. Remifentanil infusion in combination with PCB under monitored anesthesia care provided satisfactory analgesiawithout any major adverse effects in patients undergoing TUGOR