///2010 Abstract Details
2010 Abstract Details2018-05-01T17:52:49+00:00

TARGET CONTROLLED INFUSION OF PROPOFOL WITH TWO DIFFERENT FENTANYL DOSES CARE DURING OOCYTE RETRIEVAL

Abstract Number: 13
Abstract Type: Original Research

Demet Coskun Fellow, MD1 ; Berrin Gunaydin Prof2; Ayca Tas Resident, MD3; Hulya Celebi Prof4; Kadir Kaya Prof5; Ahmet Erdem Prof6

Introduction: Transvaginal ultrasound-guided oocyte retrieval (TUGOR) for in-vitro fertilization is a relatively short outpatient procedure requiring sedation and analgesia. Various sedative and/or analgesics have been used until now. Target controlled infusion (TCI) is a system that maintains particular drug concentration of a drug using standard pharmacokinetic equations. Both nitrous oxide and remifentanil have been used with TCI propofol during TUGOR (1,2. However, the efficacy of TCI propofol coadministered with intravenous bolus fentanyl has not been investigated yet. Therefore, we aimed to evaluate effectiveness of rate of TCI propofol with two different fentanyl doses in patients undergoing TUGOR.

Methods: After approval of ethic committee and written informed consent from each patient, 40 unpremedicated ASA I or II women scheduled for TUGOR were enrolled. Before starting the procedure, patient were told to evaluate their pain according to a numeric rating scale (NRS; 0 corresponding no pain and 10 corresponding to worst possible pain). NRS>3 was accepted as considerably painless. Following routine monitorization (heart rate, non invasive blood pressure and peripheral oxygen saturation: SpO2), patients were randomly allocated to administer fentanyl 1 or 1.5 g kg-1 (Group I n=20 and Group II n=20, respectively). Then TCI (Orchestra Base Prima, Fresenius, Kabi, France) propofol at effect site concentration (Ce) 1.5 g mL-1 was started initially and then, further propofol doses were adjusted according to NRS and SpO2. In case of evaluating NRS>3, propofol was increased by 0.5 μg mL-1 and decreased by 0.5 μg mL-1 when SpO2 decreased to 95%. All patients received 4 L min-1 oxygen via face mask. Rate of increase or decrease in propofol dose requirements, blood pressure, heart rate, SpO2 and the level of analgesia were recorded every 5 minute throughout the procedure. Aldrete recovery score (ARS), incidence of postoperative nausea and vomiting (PONV) and side effects were recorded.

Results: Both groups were similar with respect to demographic characteristics, ASA physical status, duration of procedure and anaesthesia. Hemodynamic variables and SpO2, were comparable between the groups. Complete ARS (time to reach 10) after 5 minutes was observed in 8 patients (40%) in Group I whereas, 4 patients (20%) in Group II. However, ARS reached to 10 after 10 minutes in both groups. Only 1 patient in Group II suffered from PONV. Pregnancy rates were 30% and 40% in Groups I and II, respectively. Patients requiring dose adjustment were similar between the groups (25% and 30% in Groups I and II, respectively).

Discussion: Fentanyl 1 g kg-1 with TCI propofol at Ce 1.5 g mL-1 seemed to be sufficient to provide satisfactory sedoanalgesia with less need for TCI rate change in patients undergoing TUGOR.

References:

1.Tsutsui FH, Kodaka. IJOA 2007

2.Coskun et al. 2009 2nd World Congress of TIVA -TCI

SOAP 2010