Conscious Sedation and Analgesia for Oocyte Retrieval

Oocyte retrieval is a necessary part of IVF treatment. Conscious sedation using a combination of midazolam for anxiolysis, propofol for sedation and alfentanil for analgesia is the commonest approach used to provide pain relief for oocyte retrieval. This chapter presents a practical overview of patient sedation for assisted conception. Recommendations are based on the framework for safe sedation practice set out by the Royal College of Anaesthetists (UK) and include pre-operative assessment, patient preparation and fasting, sedation and analgesia medication, monitoring and recovery. While conscious sedation is commonly delivered by medical practitioners, nurse-led sedation is increasingly being adopted in the fertility sector as it is both appropriate and safe with certain caveats. We also describe the development of a nurse-led sedation service within a hospital-based fertility clinic (Ninewells Assisted Conception Unit, NHS Tayside, UK), and include examples of documentation (pre-anaesthetic chart) and drug protocols developed for effective and safe practice.