Midazolam/ketamine sedative combination compared with fentanyl/propofol/isoflurane anaesthesia for oocyte retrieval

Assisted reproduction may be associated with repeated occasions of surgical intervention. Propofol, which is frequently used for induction of anaesthe sia in such procedures, has been suspected of damaging oocytes, We compared in a randomized prospective design the use of general anaesthesia with fen tanyl 0.017 mg/kg, propofol 2.5 mg/kg and isoflurane to that of sedation wi th midazolam 0.06 mg/kg and ketamine 0.75 mg/kg for transvaginal oocyte ret rieval in 50 patients with no premedication, Overall, patient satisfaction was not different between the groups. Sedated patients were more arousable than anaesthetized patients during the procedure and experienced less posto perative abdominal pain at 30 min. Despite some movement in response to pai n, oocyte retrieval was conveniently feasible in all sedated patients, of w hich none required a switch to general anaesthesia, A comparable number of oocytes was retrieved per cycle, 10.8 (+/-7.8:) versus 9.6 (+/-10.9) with s edation and anaesthesia respectively. No patient recalled any pain sensatio n during the procedure. The rate of embryo transfers and pregnancies were n ot different between the two groups, We conclude that the sedative combinat ion of midazolam and ketamine for oocyte retrieval may serve as an alternat ive for general anaesthesia.