Lucie Rolland1,2, Jeanne Perrin3,4,5, Virginie Villes6, Valérie Pellegrin3, Léon Boubli7, Blandine Courbiere3,4. 1. Department of Gynecology, Obstetrics and Reproductive Medicine, Pôle femmes parents enfants, AP-HM La Conception University Hospital, 147 bd Baille, 13005, Marseille, France. Lucierolland24@gmail.com. 2. Aix Marseille Université, CNRS, IRD, Avignon Université, IMBE UMR 7263, 13397, Marseille, France. Lucierolland24@gmail.com. 3. Department of Gynecology, Obstetrics and Reproductive Medicine, Pôle femmes parents enfants, AP-HM La Conception University Hospital, 147 bd Baille, 13005, Marseille, France. 4. Aix Marseille Université, CNRS, IRD, Avignon Université, IMBE UMR 7263, 13397, Marseille, France. 5. Department of Gynecology, Obstetric and Reproductive Medicine, Laboratory of Medical Reproduction, CECOS, AP-HM La Conception, 147 bd Baille, 13005, Marseille, France. 6. Research Unit EA3279, Department of Public Health, Aix Marseille Université, 13005, Marseille, France. 7. Department of Gynecology, Obstetrics and Reproductive Medicine, Pôle femmes parents enfants, AP-HM Hopital Nord, Chemin des bourrely, 13015, Marseille, France.
Abstract
PURPOSE: Does the type of anesthesia (paracervical block (PCB) or general anesthesia (GA)) impact live birth rate, pain, and patient satisfaction? METHODS: A non-randomized prospective cohort study was conducted in women treated for IVF. Two groups of patients were prospectively included: the PCB group (n = 234) and the GA group (n = 247). The type of anesthesia was determined by the patients. The primary endpoint was cumulative live birth rate by OR. Secondary endpoints were self-assessment of the patients' peri-operative abdominal and vaginal pain vs the doctors' evaluations during PCB, post-operative abdominal and vaginal pain level, and patient satisfaction in both groups. Pain levels were assessed with a numerical rating scale (NRS). RESULTS: The live birth rate was similar in both groups (19.8% in the GA group vs 20.9% in the PCB group, P = 0.764). During oocyte retrieval in the PCB group, the physicians significantly under-estimated the vaginal pain experienced by the patients (3.04 ± 0.173 for patients vs 2.59 ± 0.113 for surgeons, P = 0.014). Post-operative vaginal and abdominal pain were significantly greater in the PCB group compared to the GA group (2.26 ± 0.159 vs 1.66 ± 0.123, respectively, P = 0.005, and 3.80 ± 0.165 vs 3.00 ± 0.148, respectively, P < 0.001). Patients were more significantly satisfied with GA than with PBC (P < 0.001). CONCLUSION: Because the LBR was similar in both groups and patient satisfaction was high, the choice of anesthesia should be decided by the patients.
PURPOSE: Does the type of anesthesia (paracervical block (PCB) or general anesthesia (GA)) impact live birth rate, pain, and patient satisfaction? METHODS: A non-randomized prospective cohort study was conducted in women treated for IVF. Two groups of patients were prospectively included: the PCB group (n = 234) and the GA group (n = 247). The type of anesthesia was determined by the patients. The primary endpoint was cumulative live birth rate by OR. Secondary endpoints were self-assessment of the patients' peri-operative abdominal and vaginal pain vs the doctors' evaluations during PCB, post-operative abdominal and vaginal pain level, and patient satisfaction in both groups. Pain levels were assessed with a numerical rating scale (NRS). RESULTS: The live birth rate was similar in both groups (19.8% in the GA group vs 20.9% in the PCB group, P = 0.764). During oocyte retrieval in the PCB group, the physicians significantly under-estimated the vaginal pain experienced by the patients (3.04 ± 0.173 for patients vs 2.59 ± 0.113 for surgeons, P = 0.014). Post-operative vaginal and abdominal pain were significantly greater in the PCB group compared to the GA group (2.26 ± 0.159 vs 1.66 ± 0.123, respectively, P = 0.005, and 3.80 ± 0.165 vs 3.00 ± 0.148, respectively, P < 0.001). Patients were more significantly satisfied with GA than with PBC (P < 0.001). CONCLUSION: Because the LBR was similar in both groups and patient satisfaction was high, the choice of anesthesia should be decided by the patients.
Entities:
Keywords:
General anesthesia; IVF; Live birth rate; Pain relief; Paracervical block
Authors: Yoon Frederiksen; Mimi Y Mehlsen; Signe M S Matthiesen; Robert Zachariae; Hans Jakob Ingerslev Journal: J Psychosom Obstet Gynaecol Date: 2016-09-27 Impact factor: 2.949