title: Anaesthesia for ultrasound guided oocyte retrieval: midazolam/remifentanil versus propofol/fentanyl regimens.
abstract: To evaluate the quality of intra-operative anaesthesia and recovery characteristics of two different anaesthesia regimens, 60 healthy women undergoing ultrasound guided oocyte retrieval for in vitro fertilization procedures were randomly allocated to receive either a propofol/fentanyl or a midazolam/remifentanil based anaesthesia. The surgical procedure was successful in all patients and no severe side effects were reported by any patient. Four patients in the midazolam/remifentanil group (13%) would not accept the same anaesthetic procedure for further in vitro fertilization treatment due to intra-operative awareness, while all propofol/fentanyl patients were prepared to accept the same procedure again (P < 0.05). Patients in the propofol/fentanyl group required manual ventilation more frequently through a facemask than those patients treated with the midazolam/remifentanil combination (50% and 30%, respectively; P < 0.05). The time to achieve an Aldrete's score of 10 was shorter in the midazolam/remifentanil patients (2 +/- 2 min) than in those who received propofol/fentanyl (4 +/- 2 min) (P < 0.001), but no differences were observed in the time required to be 'fit to discharge' from the post-anaesthesia care unit. We conclude that the use of a midazolam/remifentanil regimen is as effective and safe as a fentanyl/propofol regimen in patients undergoing transvaginal oocyte retrieval for in vitro fertilization procedures.
authors.affiliation: Department of Anaesthesiology, University of Milan, IRCCS H. San Raffaele, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Casati
authors.forename: G
authors.initials: G
authors.lastname: Valentini
authors.forename: A
authors.initials: A
authors.lastname: Zangrillo
authors.forename: R
authors.initials: R
authors.lastname: Senatore
authors.forename: A
authors.initials: A
authors.lastname: Mello
authors.forename: B
authors.initials: B
authors.lastname: Airaghi
authors.forename: G
authors.initials: G
authors.lastname: Torri
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects; D000771:Anesthesia, Intravenous / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D019160:Endosonography; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D005307:Fertilization in Vitro; D006801:Humans; D008874:Midazolam / Q000009:adverse effects; D018587:Oocyte Donation; D010880:Piperidines / Q000009:adverse effects; D015742:Propofol / Q000009:adverse effects; D011446:Prospective Studies; D000077208:Remifentanil
chemical_list: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol