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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
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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
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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 %
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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
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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
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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
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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
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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
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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
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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
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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
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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
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14. Time, sec.
VAS
n=57
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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
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