IJCM  Vol.4 No.8 , August 2013
The Clinic Analysis of Diclofenac Suppository for Oocyte Retrieval Analgesia in IVF-ET Cycles
ABSTRACT

Objective: To study the effect of diclofenac suppository in oocyte retrieval of IVF-ET. Study Design: 1176 patients with informed consents were enrolled into this prospective randomized controlled study. The setting was an IVF-ET program at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. According to the analgesic drug use, the patients were randomly divided into pethidine group (573 cases) and diclofenac suppository group (603 cases). The data of vital signs, common adverse reactions, severe adverse events and pain degree in oocyte retrieval were collected. The IVF-ET outcomes were also compared. Results: The post-operation pressure and pulse were lower in pethidine group than in diclofenac suppository group (both P<0.001).The rest vital signs were not statistically different (all P>0.05). Common adverse reactions in diclofenac suppository group were relative less (all P<0.05). Pain degree between the two groups was not statistically different (P=0.304). IVF-ET outcomes were also not statistically different (all P>0.05). There were 3 cases serious abdominal bleeding with shock in the diclofenac suppository group. Conclusion: Using diclofenac suppository in oocyte retrieval analgesic had a good effect. And there was no adverse effect in the IVF-ET outcome. But we should pay close attention to the probability of serious abdominal bleeding.


Cite this paper
Y. Li, Q. Mai, T. Li, Y. Zhong and C. Zhou, "The Clinic Analysis of Diclofenac Suppository for Oocyte Retrieval Analgesia in IVF-ET Cycles," International Journal of Clinical Medicine, Vol. 4 No. 8, 2013, pp. 350-354. doi: 10.4236/ijcm.2013.48062.
References
[1]   N. F. Vlahos, I. Giannakikou, A. Vlachos and N. Vitoratos, “Analgesia and Anesthesia for Assisted Reproductive Technologies,” International Journal of Gynecology & Obstetrics, Vol. 105, No. 3, 2009, pp. 201-205. doi:10.1016/j.ijgo.2009.01.017

[2]   M. Vosoughin, S. Mohammadi and A. Dabbagh, “Intravenous Ketamine Compared with Diclofenac Suppository in Suppressing Acute Postoperative Pain in Women Undergoing Gynecologic Laparoscopy,” Journal of Anesthesia, Vol. 26, No. 5, 2012, pp. 732-737. doi:10.1007/s00540-012-1399-1

[3]   S. Mitra, P. Khandelwal and A. Sehgal, “Diclofenac-Tramadol vs. Diclofenac-Acetaminophen Combinations for Pain Relief after Caesarean Section,” Acta Anaesthesiologica Scandinavica, Vol. 56, No. 6, 2012, pp. 706-711. doi:10.1111/j.1399-6576.2012.02663.x

[4]   J. F. Standing, D. Tibboel, R. Korpela and K. T. Olkkola, “Diclofenac Pharmacokinetic Meta-Analysis and Dose Recommendations for Surgical Pain in Children Aged 1-12 Years,” Pediatric Anesthesia, Vol. 21, No. 3, 2011, pp. 316-324. doi:10.1111/j.1460-9592.2010.03509.x

[5]   C. Kailasam, L. P. Hunt, I. Ryder, I. Bhakri and U. D. Gordon, “Safety and Effectiveness of Diclofenac Sodium in Assisted Reproduction Treatment: A Randomized Prospective Double-Blind Study,” Reproductive BioMedicine Online, Vol. 16, No. 5, 2008, pp. 724-729. doi:10.1016/S1472-6483(10)60488-9

[6]   V. Akande, A. Garas and D. Cahill, “The Effect of Diclofenac and Paracetamol on Pregnancy and Implantation Rates in Infertile Women Undergoing IVF Treatment,” Journal of Obstetrics and Gynaecology, Vol. 26, No. 8, 2006, pp. 785-787. doi:10.1080/01443610600984578

[7]   J. F. Standing, K. Ooi, S. Keady, R. F. Howard, I. Savage and I. C. Wong, “Prospective Observational Study of Adverse Drug Reactions to Diclofenac in Children,” British Journal of Clinical Pharmacology, Vol. 68, No. 2, 2009, pp. 243-251. doi:10.1111/j.1365-2125.2009.03447.x

[8]   L. C. Hamilton, J. A. Mitchell, A. M. Tomlinson and T. D. Warner, “Synergy between Cyclo-Oxygenase-2 Induction and Arachidic Acid Supply in Vivo: Consequences for Nonsteroidal Antiinflammatory Drug Efficacy,” FASEB Journal, Vol. 13, No. 2, 1999, pp. 245-251.

[9]   H. Achache, A. Tsafrir, D. Prus, R. Reich and A. Revel, “Defective Endometrial Prostaglandin Synthesis Identified in Patients with Repeated Implantation Failure Undergoing in Vitro Fertilization,” Fertility and Sterility, Vol. 94, No. 4, 2010, pp. 1271-1278. doi:10.1016/j.fertnstert.2009.07.1668

[10]   A. Bokhari and B. J. Pollard, “Anaesthesia for Assisted Conception: A Survey of UK Practice,” European Journal of Anaesthesiology, Vol. 16, No. 4, 1999, pp. 225-230.

[11]   W. Wilhelm, M. E. Hammadeh, P. F. White, T. Georg, R. Fleser and A. Biedler, “General Anesthesia versus Monitored Anesthesia Care with Remifentanil for Assisted Reproductive Technologies: Effect on Pregnancy Rate,” Journal of Clinical Anesthesia, Vol. 14, No. 1, 2002, pp. 1-5. doi:10.1016/S0952-8180(01)00331-2

[12]   S. P. Boyers, G. Lavy, J. B. Russell and A. H. DeCherney, “A Paired Analysis of in Vitro Fertilization and Cleavage Rates of First-versus Last-Recovered Preovulatory Human Oocytes Exposed to Varying Intervals of 100% CO2 Pneumoperitoneum and General Anesthesia,” Fertility and Sterility, Vol. 48, No. 6, 1987, pp. 969-974.

[13]   P. O. Fiebai, A. A. Ogunmokun and R. A. Ajayi, “Experience with Conscious Sedation for Oocyte Retrieval in Nigeria,” African Journal of Reproductive Health, Vol. 12, No. 1, 2008, pp. 30-34.

 
 
Top