COMPARISON OF CARBON-DIOXIDE AND AIR PNEUMOPERITONEUM FOR GAMETE INTRAFALLOPIAN TRANSFER UNDER CONSCIOUS SEDATION AND LOCAL-ANESTHESIA

Objective: To compare patient tolerance and pregnancy rates (PRs) betw een two cohorts that underwent GIFT under local anesthesia with air ve rsus carbon dioxide (CO2) pneumoperitoneum. Design: Retrospective stud y. Setting: University clinic. Patient(s): Eighty-five patients who un derwent 125 laparoscopies under conscious sedation for GIFT using air pneumoperitoneum were compared with 42 patients who had 70 GIFT proced ures with CO2 pneumoperitoneum. Intervention(s): Transvaginal ultrasou nd-guided egg retrieval followed by GIFT with compressed air or CO2 fo r pneumoperitoneum under local anesthesia and IV sedation. Main Outcom e Measure(s): Patient tolerance and viable PR. Result(s): The percenta ge of patients scoring ''very good'' was lower in the CO2 group (73% f or air versus 57% for CO2), but the combined percentage of those scori ng ''very good'' or ''good'' was comparable at 89% and 87%. The differ ence in the viable PRs between the two groups (43% versus 37%) for pat ients <40 years old was not statistically significant. Conclusion(s): Patient tolerance and PRs are similar for air and CO2 pneumoperitoneum during GIFT under local anesthesia Given the theoretical risk of air embolus and lack of detrimental effect of CO2 on patient tolerance and success rate, it seems prudent to use CO2 in such a setting. (C) 1998 by American Society for Reproductive Medicine.