Subjective Assessment of Anaesthesia Quality in Patients after In Vitro Fertilization Procedure

 

Transcript

  • 1. Subjective Assessment of Anaesthesia Quality in Patients after In Vitro Fertilization Procedure. I.Ushakov1, V. Potievskaya2, K. Abramyan1. 1- Medical Center “Moskvorechye” (Moscow) 2- Russian Medical Academy of Postgraduate Education (Moscow) 2015 dok-ushakov.ru
  • 2. Anesthesia is using for IVF in following surgical procedures: • Transvaginal puncture for oocyte retrieval • Percutaneous Epididymal Sperm Aspiration (PESA) • Testicular Sperm Extraction (TESE) • Diagnostic hysteroscopy and laparoscopy dok-ushakov.ru
  • 3. Our choice is inhalational general anaesthesia with sevoflurane  it is alternative to intravenous anaesthesia  It can be used in all variants of general anaesthesia Vital Capacity Rapid Inhalation Induction (VCRII) technique is using to get high concentration of sevoflurane for further transition to maintenance anaesthesia 100% oxygen flow Anaesthetic agent Inhalation concentration on induction 6 L/min sevoflurane 7-8 % dok-ushakov.ru
  • 4. Efficacy Perfect acceptability Safety Simple management Low cost Controllability Markers of anaesthesia’s quality Patient’s satisfaction after surgery – Main marker of anaesthesia’s quality dok-ushakov.ru
  • 5. The aim of study: To reveal features of awakening / recovery after Sevoflurane anaesthesia To estimate individual preference of patients in choosing method of anaesthesia dok-ushakov.ru
  • 6. Design: Prospective study of patients undergoing oocyte retrieval under general anaesthesia. Materials and Methods: Oocyte retrievals with ultrasound assistance were made in 35 patients. The mean age was 36 years old (from 27 to 44 years). Needle dok-ushakov.ru
  • 7. Anaesthesia in the past Propofol Sevoflurane SevofluraneSevoflurane Anaesthesia for TVP Desire to change kind of anaesthesia Conversation with anaesthesiologist I group = 16 II group = 19 dok-ushakov.ru
  • 8. The assesses the clinical conditions of patients at the end of anesthesia  Activity  Respiratory  Consciousness  Circulation  02 Saturation Satisfaction with postoperative questions 1. How is estimated total comfort after anaesthesia? 2. Which anaesthesia had more short recovery time? 3. What anaesthesia, the last or previous, is more preferable in general? * 4. PONV ? The Aldrete Scoring System  Postoperative nausea and vomiting (PONV)  Visual analogue scale (VAS) *The results were evaluated with 1 to 5 grade scale.dok-ushakov.ru
  • 9. Results Postoperative nausea and vomiting weren`t note The level of recovery was ten points according Aldrete`s scale dok-ushakov.ru
  • 10. General description of the groups group Age BMI Time of Puncture (sec) Time of Awakening (sec) Propofol // Sevoflurane n=16 34,2±4,3 23,7±5,4 315±38 289±26 Sevoflurane // Sevoflurane n=19 37,2±3,9 25,9±6,1 180±27 325±28 dok-ushakov.ru
  • 11. Distribution of patients in groups according duration of surgery 0 1 2 3 4 5 6 7 8 9 10 100 150 200 250 300 350 400 450 sec Duration of TVP 0 1 2 3 4 5 100 150 200 250 300 350 400 450 500 >500 sec Duration of TVP Amountofpatients dok-ushakov.ru
  • 12. 0 1 2 3 4 5 100 150 200 250 300 350 400 450 500 >500 sec 0 1 2 3 4 5 6 100 150 200 250 300 350 400 450 500 >500 sec Spreading of patients in groups due to duration of awakening period Amountofpatients Amountofpatients Sevoflurane // SevofluranePropofol // Sevoflurane dok-ushakov.ru
  • 13. Postoperative analgesia N=57 1 group (n= 15) i.m. Nefopam -20 mg 2 group (n= 21) i.v. Nefopam 20mg + NaCl 0,9% -200ml And Ketoprofen 100 mg + NaCl 0,9%-20ml 3 group (n= 21) i.m. Nefopam 1 gr. n= 15 2 gr. n= 21 3 gr n= 21 Age (y) 33,0±4,7 31,4±5,9 34,4±4,5 weight (kg) 63,2±4,0 57,2±4,0 66,7±3,0 Time of puncture (sec) 310±48 350±34 274±20 Amount of follicles 15±3 15±2 11±1 dok-ushakov.ru
  • 14. Time, sec. VAS n=57 dok-ushakov.ru
  • 15. 0 2 4 6 8 10 12 14 16 18 0 1 2 3 4 5 Points of five point scale Estimation of satisfaction in postanaesthesia period Subjective estimation of feeling after two hours of anaesthesia Amountofpatients Propofol Sevofluranedok-ushakov.ru
  • 16. The investigation reveled evident advantage of Sevoflurane anaesthesia in comparison with propofol anaesthesia We suppose that applying of inhalation anaesthesia of sevoflurane increases level of patient`s satisfaction in ART clinic Take Home messages dok-ushakov.ru
Яндекс.Метрика