Remifentanil versus remifentanil with paracervical block on plasma remifentanil concentrations and pulmonary function tests for transvaginal ultrasound-guided oocyte retrieval
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Berrin Gunaydin1, I Kivilcim Ozulgen, Ertan Ozturk
1Department of Anesthesiology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Study Objective:
The aim of this study is to compare plasma remifentanil concentrations and pulmonary function tests in subjects receiving remifentanil infusion (RI) versus RI with paracervical block (PCB) during transvaginal ultrasound-guided oocyte retrieval (TUGOR).
Design:
Prospective, randomized.
Setting:
Assisted Conception Unit.
Patients:
Forty American Society ofAnesthesiologists I subjects requiring TUGOR.
Intervention:
After ovarian hyperstimulation, subjects were randomly allocated into two groups to receive either RI (Group RI, n = 20) or RI with PCB (Group RI + PCB, n = 20).
Measurements:
Heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation (SpO2), end tidal carbon dioxide (ETCO2) tension, forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and amount of remifentanil used were collected. Plasma remifentanil concentrations were calculated with STANPUMP software.
Main Results:
HR, MAP, ETCO2, SpO2, FEV1, and FVC did not differ between the groups. Total amount of remifentanil used were 486 +/- 1.81 microg and 321 +/- 0.87 microg in groups RI and RI + PCB, respectively, (p < 0.05). In Group RI, plasma remifentanil concentrations were 4.7 ng mL(-1) and 4.2 ng mL(-1) during the second transvaginal puncture, and at the end of TUGOR, respectively, whereas corresponding plasma remifentanil concentrations were 3.1 ng mL(-1) and 2.6 ng mL(-1) in Group RI + PCB (p < 0.05).
Conclusion:
Both anesthesia regimens provided satisfactory analgesia without affecting FEV1 and FVC, but significantly higher plasma remifentanil concentrations were calculated when only RI was used as an anesthetic technique.
