Optimizing Patient Analgesic Experience During IVF

Summary

This study is for patients undergoing In Vitro Fertilization (IVF). The investigators are studying the best way to control pain during the egg retrieval process. The egg retrieval involves passing a needle under ultrasound guidance through the vagina into the ovaries to remove eggs that are to be later fertilized. Patients often report this as very uncomfortable. Different fertility clinics across the country use different methods of pain control. All clinics will use intravenous medication to control pain, while some may or may not use local anaesthetic (freezing) in the vagina. Our goal is to find the best way to control pain. Since local anaesthetic injection involves multiple needle punctures and may be painful, the investigators are unsure if local anaesthetic is necessary in addition to the intravenous pain medication. The investigators will conduct a randomized trial where all patients will receive intravenous pain medication, but some will receive local anaesthetic injection and some will receive placebo injection. Patients will be asked to complete a questionnaire on their pain experience after oocyte retrieval. The investigators will then analyze the data and determine whether local anaesthetic actually improves pain when patients are already receiving intravenous pain medications. Through our study, the investigators aim to improve the pain experience of all women undergoing IVF in the future.

Timeline

Start

2013-03

Primary completion

2015-11-07

Completion

2015-11-07

Publications

• Background Ng EH, Tang OS, Chui DK, Ho PC. A prospective, randomized, double-blind and placebo-controlled study to assess the efficacy of paracervical block in the pain relief during egg collection in IVF. Hum Reprod. 1999 Nov;14(11):2783-7. doi: 10.1093/humrep/14.11.2783.
• Background Bhattacharya S, MacLennan F, Hamilton MP, Templeton A. How effective is patient-controlled analgesia? A randomized comparison of two protocols for pain relief during oocyte recovery. Hum Reprod. 1997 Jul;12(7):1440-2. doi: 10.1093/humrep/12.7.1440.
• Background Elkington NM, Kehoe J, Acharya U. Intravenous sedation in assisted conception units: a UK survey. Hum Fertil (Camb). 2003 May;6(2):74-6. doi: 10.1080/1464770312331369083.
• Background Bokhari A, Pollard BJ. Anaesthesia for assisted conception: a survey of UK practice. Eur J Anaesthesiol. 1999 Apr;16(4):225-30. doi: 10.1046/j.1365-2346.1999.00461.x.
• Background Vlahos NF, Giannakikou I, Vlachos A, Vitoratos N. Analgesia and anesthesia for assisted reproductive technologies. Int J Gynaecol Obstet. 2009 Jun;105(3):201-5. doi: 10.1016/j.ijgo.2009.01.017. Epub 2009 Feb 26.
• Background Sephton VC, Shaw A, Cowan CM, Thomas K, Wood S, Barclay PM, Kingsland CR. Sedation and analgesia for transvaginal oocyte retrieval: an audit resulting in a change of clinical practice. Hum Fertil (Camb). 2001;4(2):94-8. doi: 10.1080/1464727012000199361.
• Background Harrison RF, Barry-Kinsella C, Drudy L, Gordon A, Hannon K, Hennelly B, Keogh I, Kondaveeti U, Nargund G, Verso J. An Irish out-patient based in-vitro fertilisation service. Ir Med J. 1992 Jun;85(2):63-5.
• Background Gohar J, Lunenfeld E, Potashnik G, Glezerman M. The use of sedation only during oocyte retrieval for in vitro fertilization: patients' pain self-assessments versus doctors' evaluations. J Assist Reprod Genet. 1993 Oct;10(7):476-8. doi: 10.1007/BF01212936. No abstract available.
• Background Wikland M, Evers H, Jakobsson AH, Sandqvist U, Sjoblom P. The concentration of lidocaine in follicular fluid when used for paracervical block in a human IVF-ET programme. Hum Reprod. 1990 Nov;5(8):920-3. doi: 10.1093/oxfordjournals.humrep.a137220.
• Background Schnell VL, Sacco AG, Savoy-Moore RT, Ataya KM, Moghissi KS. Effects of oocyte exposure to local anesthetics on in vitro fertilization and embryo development in the mouse. Reprod Toxicol. 1992;6(4):323-7. doi: 10.1016/0890-6238(92)90195-y.

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