Comparison between target-controlled infusion of propofol, desflurane and locoregional anaesthesia for transvaginal oocyte retrieval: anaesthetic and reproductive outcome

ABSTRACT

Target controlled intravenous anaesthesia using propofol was compared with inhalational anaesthesia using desflurane and paracervical block with bupivacaine in relation to the reproductive outcome after in-vitro fertilization and embryo transfer. Data were collected prospectively on 60 women presenting for oocyte retrieval. All patients received ovarian stimulation treatment. Patients were allocated randomly to three equal groups. In both groups 1 and 2, induction of anaesthesia consisted of 0.5 mg alfentanil and 2mg /kg propofol intravenously. In group 1, anaesthesia was maintained with target controlled infusion of propofol [4 mu g/ml]. In group 2, the anaesthesia was maintained with desflurane 3%. In group 3, a paracervical block using 20 ml of 0.25% bupivacaine was performed. The results showed that there was a haemodynamic stability in the three groups. Emergence from anaesthesia occurred significantly earlier after desflurane group compared with propofol group, but complete recovery occurred significantly faster in the propofol group because of a reduced incidence of post-operative nausea and vomiting. There was no significant difference in the reproductive outcome. As regards fertilization and cleavage rates, the implantation rate was slightly lower in the propofol group but with no significant difference