Anxiolytic premedication reduces preoperative anxiety and pain during oocyte retrieval. A randomized double-blinded placebo-controlled trial.
BACKGROUND
The role of anxiolytic premedication remains unclear and significant postoperative side-effects may result from routine use.


METHODS
In this double-blinded study, 100 infertile patients were randomized on the day of ultrasound-guided oocyte retrieval (TUGOR) by a computer-generated randomization list in sealed envelopes to receive either (i) 50 mg pethidine and 25 mg promethazine (premedication group) or (ii) normal saline (placebo group) i.m. 30 min prior to TUGOR. Anxiety level, pain levels and severity of postoperative side-effects were recorded.


RESULTS
No differences were seen in demographic data, TUGOR duration, number of follicles punctured and clinical outcome. Preoperative anxiety level was significantly higher than the basal anxiety level in the placebo group only. The vaginal and abdominal pain levels during TUGOR and 4 h after TUGOR were significantly higher in the placebo group than the premedication group. Significantly more patients complained of drowsiness after TUGOR in the premedication group than the placebo group and other side-effects were comparable in both groups.


CONCLUSIONS
Routine use of anxiolytic premedication prevented an increase of preoperative anxiety level, reduced pain levels during oocyte retrieval but was associated with a higher percentage of moderate/severe drowsiness in the postoperative period.
Ng
Ernest Hung Yu
EH
Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China. nghyr@hkucc.hku.hk
Miao
Benyu
B
Ho
Pak Chung
PC
D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy* / Q000209:etiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008614:Meperidine / Q000009:adverse effects / Q000627:therapeutic use*; D009865:Oocytes; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010166:Palliative Care; D010919:Placebos; D011292:Premedication; D011398:Promethazine / Q000009:adverse effects / Q000627:therapeutic use*; D012894:Sleep Stages; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods / Q000523:psychology*; D014463:Ultrasonography
D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D010919:Placebos; D008614:Meperidine; D011398:Promethazine