A prospective randomized trial comparing patient-controlled sedation using propofol and alfentanil and physician-administered sedation using diazepam and pethidine during transvaginal ultrasound-guided oocyte retrieval.
BACKGROUND
This open label study compared the effectiveness of patient-controlled sedation (PCS), with physician-administered sedation (PAS) during transvaginal ultrasound-guided oocyte retrieval (TUGOR).


METHODS
A total of 106 patients was randomized using a computer model to receive either PCS (n = 51) or PAS (n = 55). Intra-operative sedation and co-operation were measured on a 5-point scale while severity of pain, and doctor and patient satisfaction were assessed using a 100 mm visual analogue scale. Number of oocytes retrieved and fertilization, cleavage and clinical pregnancy rates were also recorded.


RESULTS
Levels of sedation and co-operation were similar between groups. The pain score was higher in the PCS group during (mean +/- SD, 53 +/- 23 versus 35 +/- 24; P < 0.01) and 2 h after the procedure (29 +/- 27 versus 17 +/- 22; P < 0.05). Doctors were less satisfied with PCS than PAS (62 +/- 25 versus 71 +/- 26; P < 0.05) while patients were highly satisfied with both methods (76 +/- 23 versus 74 +/- 21; not significant). There were no oversedation or peri-operative complications. Fertility outcomes were similar. Patients tended to prefer PCS when given the choice of sedation method.


CONCLUSIONS
Although PCS provides less analgesia then PAS during TUGOR, it is safe, satisfactory and accepted by patients.
Lok
Ingrid H
IH
Departments of Obstetrics and Gynaecology and Anaesthesia and Intensive Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR. ingridlok@cuhk.edu.hk
Chan
Matthew T V
MT
Chan
Daniel L W
DL
Cheung
L P
LP
Haines
Christopher J
CJ
Yuen
P M
PM
D000328:Adult; D015760:Alfentanil / Q000627:therapeutic use; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use; D016292:Procedural Sedation; D003975:Diazepam / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use; D007275:Injections, Intravenous; D008614:Meperidine / Q000008:administration & dosage / Q000627:therapeutic use; D009865:Oocytes; D010146:Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D010820:Physicians; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D012449:Safety; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014463:Ultrasonography
D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D015760:Alfentanil; D008614:Meperidine; D003975:Diazepam; D015742:Propofol