Abstract
Acupuncture has pain-relief effects, but no data were available on the use of transcutaneous electric acupoint stimulation (TEAS) in pain relief during oocyte retrieval. This study was designed to examine the effect of TEAS for pain relief in women undergoing transvaginal ultrasound-guided oocyte aspiration. This single-blinded, multicenter, randomized controlled trial was performed in China between May 2013 and May 2015. The subjects were randomized to mock TEAS and TEAS. TEAS or mock TEAS was administered 30 min before oocyte retrieval until the end of the operation. The primary and secondary endpoints were the pain measured using the visual analog scale (VAS) within 1 min and 1 hour after oocyte retrieval, respectively. Serum β-endorphin levels were tested in the first 50 patients/group. 390 women were undergoing oocyte retrieval. Pain levels evaluated using VAS within 1 min (18.6 ± 1.3 vs. 24.4 ± 1.7, P < 0.01) and 1 h after oocyte aspiration (4.6 ± 0.7 vs. 6.8 ± 0.8, P < 0.05) were lower in the TEAS group than in the mock TEAS group. Nausea assessment revealed a significantly lower VAS score in the TEAS group within 1 min (1.2 ± 0.4 vs. 2.9 ± 0.7, P < 0.033). Serum β-endorphin levels were significantly higher in the TEAS group than in the mock TEAS group (11.4 ± 0.5 vs. 9.1 ± 0.4, P < 0.001) after retrieval. Serum β-endorphin levels were higher in the TEAS group after the procedure than baseline (11.4 ± 0.5 vs. 9.1 ± 0.3, P < 0.001). Oocyte retrieval causes pain and discomfort, but TEAS is effective and safe for suppressing the pain and alleviating nausea associated with the operation.
Highlights
Transvaginal ultrasound-guided oocyte aspiration is a standard procedure in the process of in vitro fertilization and embryo transfer (IVF-ET)
Oocyte aspiration is associated with pain and negative emotions. e level of pain perceived during oocyte aspiration varies widely from one individual to another and is often associated with the level of menorrhagia [1, 2]
Conventional medical analgesia (CMA) during OPU includes sedative premedication with benzodiazepine, local analgesics administered as a paracervical block (PCB), and intravenous administration of fast-acting opiates during OPU. e ideal analgesia during OPU should guarantee adequate pain relief as well as rapid onset and recovery with minimum effects on the oocytes
Summary
Transvaginal ultrasound-guided oocyte aspiration is a standard procedure in the process of in vitro fertilization and embryo transfer (IVF-ET). Conscious sedation is the most commonly used method to reduce pain during oocyte aspiration (or ovum pick-up (OPU)) [3]. E ideal analgesia during OPU should guarantee adequate pain relief as well as rapid onset and recovery with minimum effects on the oocytes. In order to increase the reproducibility of this acupuncture-like technique and to reduce invasiveness, we chose to use transcutaneous electric acupoint stimulation (TEAS), a userfriendly technique, instead of using manual needling or electroacupuncture. A similar analgesic effect has been shown to be produced by TEAS and electroacupuncture [11]. TEAS has been shown to possess analgesic effects or to potentiate standard analgesics, reducing the required doses [12,13,14,15,16]. TEAS technique provides a stable constant current output between 10 and 20 mA (at or higher than two times threshold intensity) at frequencies alternating between 2 and 100 Hz with 3 seconds each. is combination of output parameters is believed to be able to deliver the maximum analgesic effect [10]
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