A total of 152 patients were prospectively randomized to receive either a combination of high (80 Hz) and low frequency (2 Hz), 3 s each, a so-called mixed frequency, or a fixed frequency of 20 Hz during oocyte retrieval. In addition to electro-acupuncture, both groups had a paracervical block and manual acupuncture.
Sample Count
152
Control
Freq
fixed frequency group(n=76)
Experiment
mixed frequency group(n=76)
Indicator
Visual analog scale(VAS)Mean and maximum pain levels and nauseaDosage of alfentanilPain relief after the procedureTime to dischargeNumber of oocytes retrievedNumber of embryo transfersNumber of positive pregnancy tests per embryo transferNumber of clinical pregnancies
Auxiliary Medication
Both study groups received a paracervical block of 10 ml lidocaine (5 mg/ml) lidocaine hydrochloride (Lidocain?; SAD, Amternes l?gemiddelregistreringskontor I/S, Denmark). Lidocaine was injected where the aspiration needle was intended to pass through the vaginal wall. The paracervical block was applied about 1?2 min after the electro-acupuncture procedure started. No premedication was administered to either group. If sufficient pain relief was not obtained by electro-acupuncture alone, patients were supplemented with i.v. alfentanil (0.25 mg) (Rapifen; Janssen-Cilag A/S, Birkerod, Denmark). After the procedure, patients were offered additional pain relief as required in the form of either Pamol (paracetamol; Nycomed, Roskilde, Denmark) or Diclon (Diclofenac; DuraScan Medical Products AS, Odense, Denmark) in tablet form.
Stimulation Method
EA;MS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
-
CEFAR ACUS 4; Cefar, Lund, Sweden;Agistim Duo; Sedatelec, Irigny, France
2/80 Hz,3 s each, pulse duration of 0.18 ms;fixed frequency, 20 Hz, pulse duration of 0.5 ms
-
The stimulation intensity was as high as possible, just under pain threshold.
Needles were stimulated every 10th minute during oocyte retrieval
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
0.22×25 mm;0.22×40 mm
CARBO; AcuPharma A/S, Ballerup, Denmark
15-25 mm
Description The acupuncture needles (CARBO; AcuPharma A/S, Ballerup, Denmark; size 0.22 × 25 mm and 0.22 × 40 mm) were inserted 15–25 mm intramuscularly into the acupuncture points a few minutes before oocyte retrieval. In the mixed frequency group, the needles in the abdominal muscles and in the hands were connected to an electrical stimulator (CEFAR ACUS 4; Cefar, Lund, Sweden) and stimulated with an alternating frequency of 80 Hz and 2 Hz, 3 s each, and a pulse duration of 0.18 ms. In the fixed frequency group, the needles in the abdominal muscles and in the hands were connected to an electrical stimulator (Agistim Duo; Sedatelec, Irigny, France) and stimulated with a fixed frequency of 20 Hz and a pulse duration of 0.5 ms. The stimulation intensity was as high as possible, just under pain threshold. The stimulation intensity of the needles was adjusted continuously during the procedure. Well-trained nurses administered the acupuncture. At the end of the procedure, the acupuncture needles were removed. In addition to electro-acupuncture, both groups received manual acupuncture, using the acupuncture point governor vessel (GV) 20 for stimulation . Needles were stimulated every 10th minute during oocyte retrieval.
Anesthesia Method
AAA
Clinical Trial Type
prospective randomized study
Contraindications
Patients with chronic pelvic pain were excluded from the study
Effector
No differences in pain before, during or after oocyte retrieval between the two groups were seen. In the fixed frequency group, however, a higher level of anxiety (P < 0.05) before oocyte retrieval was seen, and a higher level of nausea after aspiration of one ovary (P < 0.01) was seen in the mixed frequency group. No differences were seen regarding clinical outcome parameters. Contrary to previous reports on acute and chronic pain, the analgesic effect of the mixed frequency and the fixed frequency was similar when used for short duration electro-acupuncture.
Pain relief during oocyte retrieval--exploring the role of different frequencies of electro-acupuncture.
Abstract
Electro-acupuncture has previously proven its analgesic effect in oocyte retrieval for IVF. The aim of the present prospective randomized study was to explore the optimal frequency for analgesia when electro-acupuncture was applied a few minutes prior to oocyte retrieval. A total of 152 patients were prospectively randomized to receive either a combination of high (80 Hz) and low frequency (2 Hz), 3 s each, a so-called mixed frequency, or a fixed frequency of 20 Hz during oocyte retrieval. In addition to electro-acupuncture, both groups had a paracervical block and manual acupuncture. No differences in pain before, during or after oocyte retrieval between the two groups were seen. In the fixed frequency group, however, a higher level of anxiety (P < 0.05) before oocyte retrieval was seen, and a higher level of nausea after aspiration of one ovary (P < 0.01) was seen in the mixed frequency group. No differences were seen regarding clinical outcome parameters. Contrary to previous reports on acute and chronic pain, the analgesic effect of the mixed frequency and the fixed frequency was similar when used for short duration electro-acupuncture."
