Anesthetic impact of body mass index in patients undergoing assisted reproductive technologies

• Published in: Journal of clinical anesthesia 2008-08, Vol.20 (5), p.356-363
• Main Authors: Egan, Brian, MD, Racowsky, Catherine, PhD, Hornstein, Mark D., MD, Martin, Ramon, MD, PhD, Tsen, Lawrence C., MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analgesics; Anesthesia; Anesthesia & Perioperative Care; Anesthesia, General - adverse effects; Anesthesia, General - methods; Anesthesia, Intravenous - adverse effects; Anesthesia, Intravenous - methods; Anesthesia, Spinal - adverse effects; Anesthesia, Spinal - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Assisted reproductive technologies; Biological and medical sciences; Blood pressure; Body Mass Index; Classification; Comorbidity; Female; Hospitals; Hospitals, Teaching; Humans; Infertility; Intraoperative Complications - epidemiology; Intraoperative Complications - etiology; Medical sciences; Nursing; Obesity; Obesity - complications; Oocyte Retrieval - methods; Oocyte retrieval procedures; Overweight - complications; Oxygen - metabolism; Pain; Pain Medicine; Pain, Postoperative - etiology; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Young Adult
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2008.03.003

Abstract Study Objective To determine the prevalence and anesthetic impact of obesity in patients undergoing assisted reproductive technologies. Design Retrospective analysis of a complete calendar year of oocyte retrieval procedures. Setting Center for reproductive medicine of a tertiary care university teaching hospital. Patients 1,289 ASA physical status I, II, and III women undergoing oocyte retrieval procedures. Measurements Patient demographics, body mass index (BMI), comorbid conditions, frequency and characterization of intraoperative and postoperative events, route of oocyte retrieval, and anesthetic technique were assessed. Main Results Of the 1,289 women, 33% were overweight or obese. The prevalence of gastroesophageal reflux disease, depression/anxiety, hypothyroidism, diabetes, and hypertension was associated with increasing BMI (P < 0.02). Transvaginal oocyte retrieval and the use of total intravenous anesthesia were less common with increasing BMI ( P < 0.01; P < 0.003). Oxygen desaturation occurred more frequently intraoperatively and postoperatively in patients with high BMI ( P < 0.0001), as did the reports of postoperative discomfort and the need for additional analgesia ( P < 0.001). No patients managed with spinal anesthesia experienced intraoperative desaturation or required conversion to general anesthesia with endotracheal intubation. Conclusions Patients with high BMI have a greater prevalence of comorbid conditions, require alterations in anesthetic and oocyte retrieval management, and more often experience intraoperative and postoperative events.