Abstract
Does the type of anesthesia (paracervical block (PCB) or general anesthesia (GA)) impact live birth rate, pain, and patient satisfaction? A non-randomized prospective cohort study was conducted in women treated for IVF. Two groups of patients were prospectively included: the PCB group (n=234) and the GA group (n=247). The type of anesthesia was determined by the patients. The primary endpoint was cumulative live birth rate by OR. Secondary endpoints were self-assessment of the patients' peri-operative abdominal and vaginal pain vs the doctors' evaluations during PCB, post-operative abdominal and vaginal pain level, and patient satisfaction in both groups. Pain levels were assessed with a numerical rating scale (NRS). The live birth rate was similar in both groups (19.8% in the GA group vs 20.9% in the PCB group, P=0.764). During oocyte retrieval in the PCB group, the physicians significantly under-estimated the vaginal pain experienced by the patients (3.04±0.173 for patients vs 2.59±0.113 for surgeons, P=0.014). Post-operative vaginal and abdominal pain were significantly greater in the PCB group compared to the GA group (2.26±0.159 vs 1.66±0.123, respectively, P=0.005, and 3.80±0.165 vs 3.00±0.148, respectively, P<0.001). Patients were more significantly satisfied with GA than with PBC (P<0.001). Because the LBR was similar in both groups and patient satisfaction was high, the choice of anesthesia should be decided by the patients.
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