Ultrasonically guided transvaginal oocyte retrieval is relatively short procedure that is performed on an out-patient basis. The optimal
anesthetic technique should allow good surgical
anesthesia with minimal side effects, a short recovery time, and, if possible, a high rate of successful pregnancy.
Spinal anesthesia is often used in this institution, as well as many others, for this procedure. The addition of
fentanyl may be effective for both intraoperative and
postoperative pain relief. We assessed the effect of adding
fentanyl to 1.5%
lidocaine in women undergoing ultrasonically guided oocyte retrieval. Seventy-eight women were randomized to receive 45 mg of hyperbaric 1.5%
lidocaine with or without 10 microg of
fentanyl. Visual analog scale (VAS)
pain scores were lower in the operating room (OR) (P < 0.05) and postanesthesia care unit (PACU) (P < 0.0005) for the group that received
fentanyl. In addition, the amount of
narcotic required in the PACU was less in the
fentanyl group (P < 0.005). There was no difference in VAS scores the evening of or 24 h after the procedure. The amount of
analgesics and
narcotics required after discharge was the same for both groups. Timed variables, such as time to urination, ambulation, and discharge, were the same for both groups of women. The addition of
fentanyl to
lidocaine for transvaginal oocyte retrieval results in a more comfortable patient in the OR and PACU.
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