Anaesthesia for IVF Egg Retrieval

 

 

Assume patient to be an 80 kg otherwise healthy 40 yo woman.

1.      IV access, oximeter, NIBP, O2 by Hudson mask with capnograph tubing sampling from holes in the mask (using the tip of a drawing up cannula placed through the holes.

2.      Give fentanyl 100 mcg, mixed with midazolam 2.5 mg. Some would argue that neither of these drugs are necessary. I find patients are less likely to move suddenly if they are used. Midazolam may also have an amnesic effect. However I appreciate that midazolam can lead to excessive post op sedation in a small proportion of patients.

3.      Give 50 – 70 mg propofol depending on patient factors (eg  anxiety)

4.      Place patient in lithotomy position.

5.      May need to give  propofol boluses eg 20 – 50 mg based on vital signs and patient response to stimulation.

6.      Occasionally with the doses described a patient might have prolonged apnoea with O2 saturations down into the 80’s. This may require using the anaesthetic machine circuit to apply IPPV until spontaneous  respiration resumes.