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Pain practice : the official journal of World Institute of Pain

Patient-Controlled Remifentanil Analgesia as Alternative for Pethidine with Midazolam During Oocyte Retrieval in IVF/ICSI Procedures: A Randomized Controlled Trial.


PMID 24725465

Abstract

Pethidine with midazolam-induced conscious sedation for pain relief during transvaginal oocyte retrieval for in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) procedures is associated with residual pain and oversedation. Patient-controlled analgesia (PCA) with remifentanil may serve as an alternative for pethidine. We investigated whether PCA remifentanil with diclofenac was associated with improved periprocedural pain relief than pethidine analgesia during IVF/ICSI procedures, with sedation scores, safety profiles, and patient satisfaction as secondary endpoints. Seventy-six women were randomized to receive pethidine (2xa0mg/kg i.m.) and midazolam (7.5xa0mg)-induced conscious sedation (nxa0=xa040) or PCA with remifentanil and diclofenac (50xa0mg; nxa0=xa036). The Numeric Rating Scale, McGill Pain Questionnaire (MPQ), Ramsey Sedation Scale, and a 5-day pain-and-discomfort diary were used to evaluate pain and sedation levels. There were no differences in baseline characteristics and reproductive outcomes between both groups. Periprocedural pain scores were comparable for remifentanil and pethidine groups (4 [3 to 7] vs. 6 [4 to 8]; Pxa0=xa00.13). Pain scores in the pethidine group were significantly lower at 30xa0minutes after the procedure (1 [0 to 3] vs. 2 [1 to 5]; Pxa0=xa00.016), but at cost of higher sedation levels when compared to remifentanil (4 [2 to 4] vs. 2 [2 to 2]; Pxa0

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R1908
Remifentanil hydrochloride, ≥97% (HPLC), powder
C20H28N2O5·HCl