Paracervical Block for Oocyte Retrieval: Experience at a Public Health Facility in Nigeria

Document Type : Original Article

Author

Consultant Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, College of Health Sciences, University of Ilorin, Ilorin; Nigeria

Abstract

Background: Transvaginal Ultrasound Guided Oocyte Retrieval
(TUGOR) for in vitro fertilization is one of the most common minor
surgical procedures. Despite this, it is stressful and painful for the
patient and thus requires some form of analgesia with or without sedation. The effects of various anesthetic techniques used for TUGOR
on reproductive outcomes remain controversial.
Aims: This study assessed patients’ perception of pain using paracervical block and its effect on IVF outcomes.
Methods: A cross sectional study of 66 eligible patients that underwent assisted reproduction program in our facility. All clients were
treated with antagonist protocol for Controlled Ovarian Hyperstimulation. Self- administered questionnaires was used as the research instrument. Pain was assessed using a 10cm Visual Analogue Scale while
clients’ overall satisfaction was rated using Likert scoring system.
Results: Client’s aged 32.8 ±3.4. More than half had primary infertility with mean duration of 4.6 ± 2.4. Female factor infertility was
the commonest cause of infertility. The pregnancy rate per embryo
transfer was 36.4%, miscarriage rate was 9.1%, while the live rate
was 27.3%. The mean VAS scores at 1hour, 6 hours, 24 hours and
at embryo transfer were 7.1 ± 2.8, 4.6 ±1.4, 2.8 ±1.2 and 1.0 ± 0.9
respectively. The mean Likert score was 2.4 ± 0.9.
Conclusion:Paracervical block is a safe and effective anaesthesia/
analgesia option for TUGOR.
However a multimodal approach of analgesia/anaesthesia for TUGOR is recommended to further improve on clients’ satisfaction and
acceptance.

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