Conscious sedation with and without paracervical block for transvaginal ultrasonically guided oocyte collection: A comparison of the pain and sedation levels, and postoperative side effects

Background: The quality of intraoperative analgesia with paracervical block (PCB) during egg collection in in-vitro fertilization (IVF) is still unclear.
Objective: This study performed to compare the pain levels during egg collection and the subsequent intra and postoperative side effects in patients receiving a conscious sedation with and without paracervical block.
Materials and methods: In this prospective, double-blind, and placebo–controlled study, 60 patients undergoing egg collection in their first IVF cycle were randomized to receive conscious sedation in conjunction with paracervical block with 10 ml lidocaine 1.5% (sedation + PCB patients or study group) or with 10 ml normal saline (sedation patients or placebo group).
Results: Patients in study group experienced significantly less vaginal (10.40±8.40 mm vs 20.77±4.60 mm respectively; p<0.0005) and abdominal pain (10.87±5.08 mm vs 35.33±4.27 mm respectively; p<0.0005) during egg collection, compared with those in placebo group. Propofol requirements was 8.67±2.42 mg in PCB patients vs 25.60±5.29 mg in placebo group (p<0.0005). Incidence of intraoperative (9.90% vs 50% respectively; p=0.002) and postoperative (3.33% vs 56.66% respectively; p<0.0005) side effects were significantly less in study patients compared with placebo group.
Conclusion: Conscious sedation with PCB appears to be an effective and safe method of providing analgesia and anesthesia for transvaginal retrieval of oocyte.

Keywords
Transvaginal egg collection, Conscious sedation, Paracervical block, Pain relief