doiSerbia

Analysis of the applied technique of intravenous anesthesia for in vitro fertilization in obese and patients with normal body mass index

Videnović Nebojša (Faculty of Medicine, Kosovska Mitrovica + Spebo Medical Special Hospital for Fertility Treatments, Leskovac, Serbia)
Mladenović Jovan (Faculty of Medicine, Kosovska Mitrovica, Serbia)
Pavlović Aleksandar (Faculty of Medicine, Kosovska Mitrovica, Serbia)
Trpković Slađana (Faculty of Medicine, Kosovska Mitrovica, Serbia)
Filipović Milan (Faculty of Medicine, Kosovska Mitrovica, Serbia)
Marković Nebojša (Spebo Medical Special Hospital for Fertility Treatments, Leskovac, Serbia)
Stojković Miodrag (Spebo Medical Special Hospital for Fertility Treatments, Leskovac, Serbia + Faculty of Medical Sciences, Kragujevac, Serbia)

Introduction/Objective. In this study, the effects of applied anesthetic techniques were investigated in a retrospective analysis of obese patients and those with normal body mass index undergoing in vitro fertilization, using bispectral index as an indicator of anesthetic depth. Methods. In total 116 patients with normal body mass index were allocated to group N. Another 116 patients with body mass index > 30 kg/m2 were allocated to group O. Anesthetic protocol comprised midazolam for premedication, diclofenac for pre-emptive analgesia, propofol for induction and maintenance, alfentanil for analgesia, suxamethonium for muscle relaxation. We recorded and compared the monitored parameters using t-test and χ2 test. Results. Procedure duration and recovery time were significantly longer in O group (p < 0.01). There is a statistically significant difference (p = 0.000181) in the number of patients requiring mechanical ventilation after induction of anesthesia. Propofol consumption was significantly higher (p < 0.0001) in O group (2.7 ± 1.6 mg/kg) as compared to group N (2.1 ± 0.4 mg/kg). The incidence of postoperative nausea and vomiting was observed in six patients in N group (5.17%) and nine patients in O group (7.76%). Pain intensity was found higher in group O compared to group N (p < 0.0001). Assessment of patients’ sedation using verbal scale reported no statistically significant difference between N and O groups (p = 0.2548). Conclusion. Induction and maintenance of anesthesia in obese patients results in increased consumption of propofol and the need for muscle relaxation. The statements of the patients who underwent the procedure under intravenous propofol and alfentanil serve as the best recommendation for clinical practice.

Keywords: oocyte retrieval, pain, propofol, alfentanil, body weight