Anxiolytic premedication reduces preoperative anxiety and pain during oocyte retrieval. A randomized double-blinded placebo-controlled trial

Abstract

Background: The role of anxiolytic premedication remains unclear and significant postoperative side-effects may result from routine use. Methods: In this double-blinded study, 100 infertile patients were randomized on the day of ultrasound-guided oocyte retrieval (TUGOR) by a computer-generated randomization list in sealed envelopes to receive either (i) 50 mg pethidine and 25 mg promethazine (premedication group) or (ii) normal saline (placebo group) i.m. 30 min prior to TUGOR. Anxiety level, pain levels and severity of postoperative side-effects were recorded. Results: No differences were seen in demographic data, TUGOR duration, number of follicles punctured and clinical outcome. Preoperative anxiety level was significantly higher than the basal anxiety level in the placebo group only. The vaginal and abdominal pain levels during TUGOR and 4 h after TUGOR were significantly higher in the placebo group than the premedication group. Significantly more patients complained of drowsiness after TUGOR in the premedication group than the placebo group and other side-effects were comparable in both groups. Conclusion: Routine use of anxiolytic premedication prevented an increase of preoperative anxiety level, reduced pain levels during oocyte retrieval but was associated with a higher percentage of moderate/severe drowsiness in the postoperative period.