丙泊酚芬太尼静脉全麻对取卵患者卵泡液中IL-1β和TNF-α的影响

Effects of general anesthesia with intravenous administration of propofol and fentanyl on il-1β and TNF-α in follicular fluid of patients with oocyte retrieval

目的通过观察丙泊酚芬太尼静脉全麻取卵过程中卵泡液中IL-1β和TNF-α等细胞因子的变化,探讨其对卵子及妊娠结局的影响。方法选IVF-ET患者50例,随机分为两组,对照组和静脉全麻组,每组25例。于手术开始后5、10、15和20 min收集主导卵泡液测定卵泡液中IL-1β和TNF-α水平变化,并记录术后VAS评分及胚胎移植日获卵数、胚胎评分及最终妊娠结局。结果静脉全麻组患者上述时间点卵泡液IL-1β和TNF-α水平变化与对照组相比差异均无统计学意义(P>0.05);组内上述时间点变化比较差异均无统计学意义(P>0.05)。静脉全麻组术后疼痛明显低于对照组(P<0.01)。静脉全麻组患者胚胎移植日获卵数、胚胎评分及最终妊娠结局与对照组相比差异均无统计学意义(P>0.05)。结论丙泊酚静脉全麻在30 min内总量小于7 mg/kg不影响卵泡液细胞因子水平变化,镇痛良好,并发症少,可安全用于IVF-ET患者取卵术。

【Objective】To discuss the influences of general anesthesia with intravenous administration of propofol and fentanyl on ovum and the final gestation outcome, through observation of the changes of cytokines such as IL-1β and TNF-α in follicular fluid during the oocyte retrieval under their general anesthesia.【Methods】50 IVFET patients were randomly assigned into two groups： the control group and the anesthesia group, with 25 patients in each group. Predominance follicular fluid was collected respectively at 5 min, 10 min, 15 min and 20 min after the start of the surgery, the levels of IL-1β and TNF-α in follicular fluidwere determined. And the VAS points, number of obtained ovum on implantation day, embryo scores and the final gestation outcome were recorded. 【Results】There was no significant difference between the groups in terms of IL-1β and TNF-α changes at the same time points（P〉0.05）; And the differences of IL-1β and TNF-α changes in the anesthesia group at the same time points were also not significant（P〉0.05）. Postoperative pain in anesthesia group was significantly lower than the control group（P〈0.01）. In anesthesia group, the number of obtained ovum, embryo scores and the final gestation outcome were not significant compared with the control group（P〉0.05）.【Conclusion】Anesthesia with propofol（total dose7mg/kg within 30min） combined with fentanyl did not influence cytokine in follicular fluid. It is effective with few complications, which can be safely used in oocyte retrieval of IVF-ET patients.