None listed
Conditions
Brief summary
The majority of oocyte retrievals are currently performed through a transvaginal approach with ultrasonographic guidance. When receiving this procedure, most patients will suffered from painful sensation and move their legs during insertion of transvaginal ultrasound probe and aspiration needle. We anesthesiologists provide proper sedation and analgesics in order to keep patient’s steady position so that obstetricians can perform oocyte retrieval smoothly. Target controlled infusion (TCI) is considered the best way to maintain perioperative sedation since the device enable the drug concentration in the blood or plasma, or at the effect site, to be controlled continuously. According to past animal studies, sleep deprivation potentiated the ability of certain inhalation agent (isoflurane) and intravenous anesthetics (propofol) to produce loss of righting reflex in deprived rats. Besides, recent studies indicated that propofol may induces sedation by increasing firing of GABAergic neurons in the VLPO (ventrolateral preoptic nucleus) which was also known as a key area in non-rapid eye movement (NREM) sleep-promoting pathway. However, the presence of regulatory interactions between anesthesia and sleep was not confirmed currently. Thus, we design this study trying to figure out the relationship between sleep quality and target effect-site propofol concentration of TCI during a patient receiving transvaginal oocyte retrieval. Pittsburgh Sleep Quality Index was used to evaluate the patients’ sleep quality and the questionnaire will be completed before the procedure. During oocyte retrieval, Entropy monitoring will be set to assess anesthetic depth and the predicted Ceprop as well as time required for loss of consciouness (loss of response to verbal commands), total sedation time, propofol comsuption, and emergence time will be recorded. After the procedure was completed, the patients were assigned to two groups based on the result of Pittsburgh Sleep Quality Index. Patients with total score less than or equal to 5 was included in the group of good sleep quality and total score greater than 5 was assigned to the group of poor sleep quality. The data collected will be analyzed to decide whether poor sleep quality results in low target effect-site propofol concentration required for adequate sedation during transvaginal oocyte retrieval or not.
Interventions
For the female adult patients who receive transvaginal oocyte retrieval, we use propofol target-controlled infusion as sedation. The initial TCI effect-site concentrations of propofol (Ceprop) was set at 4.0 microgram/ml and Ceprop was adjusted in steps of 0.2 microgram/ml to keep Entropy value at between 40 and 60. The propofol infusion begin before the insertion of the ultrasound probe and stopped when the probe was removed from the vagina. Later, the patients were assigned to two groups based
For the female adult patients who receive transvaginal oocyte retrieval, we use propofol target-controlled infusion as sedation. The initial TCI effect-site concentrations of propofol (Ceprop) was set at 4.0 microgram/ml and Ceprop was adjusted in steps of 0.2 microgram/ml to keep Entropy value at between 40 and 60. The propofol infusion begin before the insertion of the ultrasound probe and stopped when the probe was removed from the vagina. Later, the patients were assigned to two groups based on the result of Pittsburgh Sleep Quality Index. Patients with total score less than or equal to 5 was included in the group of good sleep quality and total score greater than 5 was assigned to the group of poor sleep quality. The data collected will be analyzed to decide whether poor sleep quality results in low target effect-site propofol concentration required for adequate sedation during transvaginal oocyte retrieval or not.
Sponsors
Changhua Christian Hospital, Taiwan (R.O.C.)
Eligibility
Sex/Gender
All
Age
20 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
Female patients assessed as the American Society of Anesthesiologists (ASA) physical status classification system class I and II who are ready for transvaginal oocyte retrieval
Exclusion criteria
(1) refusal to provide informed consent, (2) allergy to intravenous propofol, fentanyl, or lidocaine, (3) hepatic, renal, or neurological dysfunction
Outcome results
None listed