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Comparative Study
General anesthesia versus monitored anesthesia care with remifentanil for assisted reproductive technologies: effect on pregnancy rate.
- Wolfram Wilhelm, Mohamad E Hammadeh, Paul F White, Thomas Georg, Rosine Fleser, and Andreas Biedler.
- Department of Anesthesiology and Intensive Care Medicine, University of Saarland, Homburg/Saar, Germany.
- J Clin Anesth. 2002 Feb 1; 14 (1): 1-5.
Study ObjectivesTo compare the outcome of assisted reproductive technology procedures in women who undergo monitored anesthesia care (MAC) with remifentanil versus general anesthesia.DesignRetrospective data analysis.SettingUniversity hospital.Patients251 ASA physical status I and II women participating in an in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) program.InterventionsDuring the first phase of the study, all patients underwent general anesthesia induction with alfentanil, propofol, and nitrous oxide, which was maintained with isoflurane or propofol infusion. In the second phase of the study, all patients received a standardized MAC technique with a remifentanil infusion; local anesthetics were not used.MeasurementsThe primary endpoint was pregnancy rate per transfer. The number of oocytes collected, fertilized, and cleaved was recorded, as was the number of oocytes transferred.Main ResultsPatients who underwent MAC had a greater pregnancy rate with IVF (28.2 vs. 16.3%), with ICSI (32.2% vs. 18.8%), and overall (30.6% vs. 17.9%).ConclusionsPregnancy rates in women undergoing transvaginal oocyte retrieval for assisted reproductive technologies were significantly higher with a remifentanil-based MAC technique than with a general anesthetic technique.
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