经阴道超声引导下穿刺取卵术镇痛方式的研究进展

doi:10.12280/gjszjk.20230195

摘要/Abstract

摘要：

经阴道超声引导下穿刺取卵术（transvaginal ultrasound-guided oocyte retrieval，TUGOR）作为体外受精-胚胎移植（in vitro fertilization-embryo transfer，IVF-ET）过程中的重要环节，其镇痛方式包括全身麻醉、清醒镇静和镇痛、患者自控镇痛、区域麻醉、宫颈旁阻滞及针灸等。经静脉全身麻醉应用最广泛，起效快、效能强，还有助于增加获卵数；异丙酚是目前最常用的静脉麻醉药物。但是，异丙酚可能对卵母细胞的毒性作用不容忽视，有研究提示卵母细胞提取过程应尽可能短，以降低麻醉药物在卵泡液中的积累。针灸作为中医学特色疗法，需进一步探讨TUGOR术中的神经传导通路和疼痛缓解的分子机制，以确定最佳的针灸镇痛方法。一些女性患者自愿选择无麻醉下取卵，一般用于卵泡较少的患者，仍需进一步研究其安全性和总体可接受度。

关键词: 生殖技术，辅助, 体外受精, 胚胎移植, 卵母细胞抽取, 镇痛

Abstract:

Transvaginal ultrasound-guided oocyte retrieval (TUGOR) is an important step of in vitro fertilization-embryo transfer (IVF-ET). The analgesia methods of TUGOR include general anesthesia, conscious sedation and analgesia, patient self-controlled analgesia, regional anesthesia, paracervical block, and acupuncture and moxibustion. Among them, intravenous general anesthesia is the most widely used, with the fast effect, strong efficiency and helps to increase the number of eggs obtained. Propofol is the most commonly used as an intravenous anesthetic drug at present. However, the possible toxic effect of propofol on oocytes should not be ignored, and some studies suggest that the oocyte extraction process should be as short as possible so as to decrease the accumulation of anesthetic drugs in follicular fluid. As a characteristic treatment of Chinese traditional medicine, acupuncture and moxibustion needs to be explored further the nerve pathway and the molecular mechanism of pain relief in TUGOR to determine the best acupuncture and moxibustion analgesia method. Some female patients with fewer follicles have voluntarily chosen the non-anesthetic oocyte retrieval, but its safety and overall acceptability need to be further studied.

Key words: Reproductive techniques, assisted, Fertilization in vitro, Embryo transfer, Oocyte retrieval, Analgesia

牛国燕, 熊正方. 经阴道超声引导下穿刺取卵术镇痛方式的研究进展[J]. 国际生殖健康/计划生育杂志, 2023, 42(6): 507-512.

NIU Guo-yan, XIONG Zheng-fang. Research Progress on Analgesic Methods for Transvaginal Ultrasound-Guided Oocyte Retrieval[J]. Journal of International Reproductive Health/Family Planning, 2023, 42(6): 507-512.

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