Effect Of Combined Application Of Tetracaine Mucilage During Oocyte Retrieval On Perioperative And Clinical Outcomes Of Patients

Background: In recent years,the incidence of infertility has increased year by year,and the reproductive capacity of the pregnant population has declined.The number of subjects requiring in vitro fertilization and embryo transfer has increased gradually.However,oocyte extraction is still the most painful step in the process of diagnosis and treatment.In order to satisfy the patients' pursuit of painless treatment,it is necessary to explore a new way of narcotic analgesia.Combined with the current mainstream intravenous anesthesia,this experiment is designed to combine intravenous anesthesia with tetracaine mucilage to improve the safety and comfort during the process of oocyte retrieval.In theory,the stability of tetracaine mucilage can provide excellent anesthetic effect,and its lubrication is conducive to the operation.The application of tetracaine may reduce the use of intravenous anesthetics in operation which may have potential harm to oocyte.We will explore the effect of tetracaine mucilage on the perioperative period of oocyte retrieval patients through clinical experiments,and preliminarily explore its impact on clinical outcomes.Methods: 1.Approved by the Reproductive Ethics Committee of the Tenth People's Hospital of Shanghai(Approval Number: SHSY-RPIEC-19-01/01).From August 2017 to June 2018,seventy subjects who met the inclusion criteria of in vitro fertilization and embryo transfer in the reproductive center of Shanghai 10 th people's hospital were enrolled in this study.According to the actual situation of the subjects,the standard microstimulation program,long program,short program and antagonist program in the reproductive center of Shanghai 10 th people's hospital were used to promote ovulation for a total of 70 cycles.The experimental group(group A,n=35)and the control group(group B,n=35)were randomly and single-blind included.2.Group A: An 8 g tetracaine mucilage was squeezed into the vaginal fornix 10 minutes before operation,and anesthesia was induced and maintained with propofol.Sufentanil was used for analgesia.Group B: Anesthesia induction and maintenance with propofol,analgesia with sufentanil,the same dosage as group A.3.Total amount of propofol and sufentanil during anesthesia,intraoperative hemodynamic indexes,operation time,anesthesia time,recovery time,postoperative VAS pain score,postoperative satisfaction score and intraoperative adverse reactions of the two groups of subjects were compared,and the perioperative effects of tetracaine gel on the subjects were studied.4.The number of oocyte obtained,fertilization rate,rate of high quality embryos and clinical pregnancy rate were compared between the two groups,and the influence of tetracaine gel on the clinical outcome were analyzed.Results: 1.The dose of propofol in the experimental group A was lower than that in the control group B.The operation time and anesthesia time were lower than those in the B group.The difference was statistically significant(P<0.05).2.There were no significant differences in intraoperative hemodynamic parameters,recovery time and postoperative adverse reactions between group A and group B(P>0.05).3.The postoperative satisfaction of group A was higher than that of group B(P>0.05).There was no significant difference in postoperative VAS score between the two groups(P>0.05).4.There were no statistically significant differences in the number of eggs obtained,the rate of fertilization,the rate of optimal embryos and the rate of clinical pregnancy among subjects in group A and group B(P>0.05).Conclusion: 1.Tetracaine mortar combined with intravenous anesthesia can reduce the amount of sedatives and operation time,which has clinical significance.2.Tetracaine mortar does not affect intraoperative hemodynamics,increase adverse reactions and affect anesthesia resuscitation,is safe and feasible.3.The use of tetracaine mortar can improve patients' satisfaction and relieve pain after operation.4.Intravenous anesthesia combined with tetracaine mortar had no significant adverse effect on the clinical outcomes of the subjects.