| Objective 1.To definite the safety and reliability of propofol intravenous anesthesia in oocyte retrieval;2.To investigate whether propofol can inhibit the number of NK cells in patients to improve the pregnancy rate.Methods The subjects of the study were 110 patients,aged between 20 and 40 years old,who underwent in vitro fertilization and embryo transfer(IVF-ET)in the Department of Reproductive Medicine,affiliated Hospital of Binzhou Medical College,between September 2017 and May 2018.The patients were randomly divided into two groups:propofol painless oocyte retrieval group(Group P,n=55),routine oocyte retrieval group(Group C,n=55).The clinical data of the patients were collected before operation,and the vital signs were monitored and detected after the patients entered the room,and then establishment of venous access.In group P,undergoing the slow intravenous infusion of propofol in 2-2.5 mg/kg,Group C was a blank control without any treatment.The operation began after the patient’s Ramsay sedation score reached 6 points and then intravenous maintenance of propotol in 8-12mg/kg/h.Mean arterial pressure,heart rate and pulse oxygen saturation were observed and recorded before anesthesia induction(T0),immediately after operation(Ti),immediately after operation(T2)and 10 minutes after operation(T3).And the visual analog scale(VAS)were recorded in T3.Venous blood samples were collected from To,T2,the morning of the first day after operation(T4)and before embryo transfer(T5)and the number of NK cells was detected by flow cytometry.The differences of the number of eggs obtained,the rate of egg acquisition,the rate of fertilized egg formation,the rate of embryo formation,the clinical pregnancy rate,the rate of early abortion and other pregnancy outcomes were compared between the two groups were compared.Results In terms of vital signs,there was no significant difference between group P and group C at T0(P>0.05).Compared to T0,there was significant difference in the term of mean arterial pressure at Ti and T2(P<0.05),at the meanwhile,the vital signs of heart rate were significant between Ti、T2 and T3.There was a transient decrease in SpO2 at T1.The patients of group C was significantly higher in heart rate and mean arterial pressure from T0 to Ti、T2,but the pulse oxygen saturation value did not change significantly at each time.The VAS score in group P was significantly lower than that in group C at T3 time(P<0.05),there was no significant difference in the number of NK cells between group P and group C at To(P>0.05);At the time of T2,the number of NK cells in group A and C decreased significantly,which was significantly different from that at T0.Compared with group C,the decrease of NK cells in group P was more obvious at T2,and there was significant difference between the two groups.There was significant difference in the number of punctured follicles and the number of eggs obtained between the two groups(P<0.05),but there was no significant difference in the formation rate of fertilized eggs,the rate of high quality embryos,the rate of early abortion and the rate of clinical pregnancy.Conclusion Intravenous anesthesia with propofol can reduce the number of NK cells in patients undergoing oocyte retrieval.Although it has no significant effect on the outcome of single pregnancy,it can achieve a higher rate of oocyte acquisition and promote the outcome of subsequent pregnancy.There was no significant difference in fertilized egg formation rate,embryo formation rate and early abortion rate between the two groups,suggesting that propofol could be safely used in oocyte retrieval.At the same time,propofol intravenous anesthesia can better maintain hemodynamic stability,alleviate patients’tension and anxiety,reduce intraoperative body reaction,reduce postoperative pain,and promote the development of comfortable medicine. |
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