Office laparoscopy under local anesthesia for gamete intrafallopian transfer: technique and tolerance.
OBJECTIVE
To describe our technique for laparoscopic GIFT under local anesthesia and to evaluate patient tolerance and surgeon satisfaction in 175 consecutive procedures.


METHODS
Prospective cohort study.


METHODS
University infertility practice.


METHODS
All GIFT candidates from 1992 to 1996 were offered the procedure. Of 119 patients, 119 chose local anesthesia for 175 procedures and 1 patient elected to have general anesthesia.


METHODS
Transvaginal ultrasound-guided egg retrieval followed by GIFT in the clinic procedure room with a 5-mm laparoscope and two accessory 3-mm trocars with local anesthesia and i.v. sedation.


METHODS
Patient tolerance and acceptance, duration of the procedure, amount of analgesics, surgeon satisfaction, and pregnancy rate (PR).


RESULTS
The laparoscopic portion lasted an average of 27 minutes, with a mean dose of 1.41 mg of midazolam and 68 micrograms of fentanyl used. Sixty-nine percent of the patients scored "very good," 20% "good," 9% "acceptable," and 2% "poor." All 38 patients undergoing 97 repeat procedures selected local anesthesia again. For women < 40 years of age, clinical PR and delivery rate were 43% and 38%, respectively.


CONCLUSIONS
Routine office GIFT under local anesthesia is effective and well accepted by the surgeon and is preferred by patients. It offers a significant cost containment and scheduling flexibility in addition to high success rates.
Milki
A A
AA
Department of Gynecology and Obstetrics, Stanford University School of Medicine, California 94305, USA.
Tazuke
S I
SI
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000523:psychology; D000772:Anesthesia, Local / Q000523:psychology; D018686:Anesthetics, Intravenous; D015331:Cohort Studies; D016292:Procedural Sedation / Q000523:psychology; D005260:Female; D005283:Fentanyl; D015181:Gamete Intrafallopian Transfer / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives; D010535:Laparoscopy / Q000523:psychology; D008874:Midazolam; D017060:Patient Satisfaction; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D012086:Reoperation
D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008874:Midazolam; D005283:Fentanyl