Anesthesia for in vitro fertilization: The addition of fentanyl to 1.5% lidocaine

Ultrasonically guided transvaginal oocyte retrieval is relatively short pro cedure that is performed on an outpatient basis. The optimal anesthetic tec hnique should allow good surgical anesthesia with minimal side effects, a s hort 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 in traoperative and postoperative pain relief. We assessed the effect of addin g fentanyl to 1.5% lidocaine in women undergoing ultrasonically guided oocy te retrieval. Seventy-eight women were randomized to receive 45 mg of hyper baric 1.5% lidocaine with or without 10 mu g of fentanyl. Visual analog sca le (VAS) pain scores were lower in the operating room (OR) (P < 0.05) and p ostanesthesia care unit (PACU) (P < 0.0005) for the group that received fen tanyl. 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 narcot ics required after discharge was the same for both groups. Timed variables, such as time to urination, ambulation, and discharge, were the same for bo th groups of women. The addition of fentanyl to lidocaine for transvaginal oocyte retrieval results in a more comfortable patient in the OR and PACU. Implications: This study demonstrates that when fentanyl is added to a loca l anesthetic, lidocaine, with spinal anesthesia for egg retrieval procedure s, patients are more comfortable during the procedure compared with those w ho receive lidocaine alone. In addition, the narcotic requirements of patie nts are less in the postanesthesia care unit.