RESUMO
OBJECTIVE: To evaluate efficacy of Propofol at Cp 2.5 µg/ ml administered by Target Controlled Infusion (TCI) using Marsh Modified Model, in pre-medicated with midazolam/ fentanil Latin-American women (Venezuelans) during oocyte retrieval for In Vitro Fertilization. METHODS: Prospective, descriptive study included 72 women, 18-44 years old, ASA I-II, non obese, undergoing oocyte retrieval, pre-medicated with midazolam 0.04 mg/kg and fentanil 2µg/kg and received anesthesia based in Propofol at Cp 2.5µg/ml by Target Controlled Infusion using Marsh Modified Model. Demographic data, propofol doses, duration of procedure and recovery time was registered using descriptive statistic. Anesthesia efficacy was measured by Biespectral Analysis (BIS), Intra-Operative Movements Scale (0 to 5) graded, Postoperative Pain by Visual Analog Scale (VAS) and nausea/vomits incidence. ANOVA and Pearson Chi2 were used with an error of 0.05. RESULTS: Age average was 33.04±6 years old, procedure average time 18.06±8min, Propofol total doses 146.64±53 mgs, Propofol infusion doses average 155.2±3µg/Kg/min. During procedure, 70.8% of patients had no movement, 22.2% movement Grade I and 6.9% Grade II. (Grade I-II movement did not interfere with procedure continuity). 70.8% achieved BIS 40-50 and 93.1% had BIS equal o less than 60. There was a statistic significant correlation between BIS 40-50 and no movements. Recovery post-anesthesia time was 25.2±8 min. 98.6% of patients reported excellent comfort. CONCLUSION: With midazolam/fentanil pre-medication, Propofol at Cp 2.5µg/ml by TCI using Marsh Modified Model showed a 93% of effectiveness during oocyte retrieval in Latin-American women subjected to IVF, allowing an ultra- fast recovery time.
RESUMO
Se determinaron los niveles de progesterona en vena del cordón umbilical y vena periférica materna y su relación con el sufrimiento fetal agudo y la vía del parto; en sesenta pacientes embarazadas a término, que fueron divididas en dos grupos: cesáreas electivas (control) y sufrimiento fetal agudo (parto vaginal y cesárea). Se realizó análisis estadístico con t de Student (p<0,05). Los resultados confirmaron que la presencia del sufrimiento fetal agudo y el parto vaginal estan asociados con el aumento de la concentración de la progesterona en vena de cordón umbilical (p<0,01) e igualmente la baja puntuación de Apgar (0,001). La concentración de progesterona materna no mostró diferencia estadística en los grupos. El aumento en la concentración de progesterona en vena del cordón umbilical podría ser un mecanismo para la protección del feto contra las secuelas de la hipoxia.