Anesthetic impact of body mass index in patients undergoing assisted reproductive technologies.
OBJECTIVE
To determine the prevalence and anesthetic impact of obesity in patients undergoing assisted reproductive technologies.


METHODS
Retrospective analysis of a complete calendar year of oocyte retrieval procedures.


METHODS
Center for reproductive medicine of a tertiary care university teaching hospital.


METHODS
1,289 ASA physical status I, II, and III women undergoing oocyte retrieval procedures.


METHODS
Patient demographics, body mass index (BMI), comorbid conditions, frequency and characterization of intraoperative and postoperative events, route of oocyte retrieval, and anesthetic technique were assessed.


RESULTS
Of the 1,289 women, 33% were overweight or obese. The prevalence of gastroesophageal reflux disease, depression/anxiety, hypothyroidism, diabetes, and hypertension was associated with increasing BMI (P < 0.02). Transvaginal oocyte retrieval and the use of total intravenous anesthesia were less common with increasing BMI (P < 0.01; P < 0.003). Oxygen desaturation occurred more frequently intraoperatively and postoperatively in patients with high BMI (P < 0.0001), as did the reports of postoperative discomfort and the need for additional analgesia (P < 0.001). No patients managed with spinal anesthesia experienced intraoperative desaturation or required conversion to general anesthesia with endotracheal intubation.


CONCLUSIONS
Patients with high BMI have a greater prevalence of comorbid conditions, require alterations in anesthetic and oocyte retrieval management, and more often experience intraoperative and postoperative events.
Egan
Brian
B
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Racowsky
Catherine
C
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Hornstein
Mark D
MD
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Martin
Ramon
R
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Tsen
Lawrence C
LC
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. Electronic address: ltsen@zeus.bwh.harvard.edu.