Why do I need an anesthetic and what will it be?
Egg retrievals would be quite uncomfortable without an anesthetic of some kind. For several years, Shady Grove Fertility has been using what is called light general anesthesia, “unconscious” sedation, heavy sedation, or total intravenous anesthesia (TIVA)—all the same thing. It is a quick sleep and a rapid wake up with little “hangover” or groggy feeling. We use this as our primary anesthetic because it is very well tolerated and the one our patients prefer. Also, because our pregnancy rate is so exceptional we have chosen to stay with a technique that works. We also use this same anesthetic for cyst and fluid aspirations, hysteroscopies, and D&Cs. All of the drugs we use go through an intravenous line, which we routinely start with a local anesthetic. You will also be breathing oxygen through a nasal cannula.
Male procedures are done with this same anesthetic technique. In addition, the physician uses local anesthetic injections prior to starting the procedure. If the procedure is certain to only be a percutaneous epididymal sperm aspiration (PESA), it can be done with local anesthesia only without any sedation. Check with your physician about your choice of anesthesia. If a PESA is not a certainty it is best to be sedated/anesthetized for the procedure so as not to be uncomfortable and create a delay in going to the next more invasive step, which is usually a testicular sperm aspiration, or occasionally a testicular biopsy
What about eating and drinking before this anesthetic?
Do not eat any food or drink any liquids after midnight on the night prior to your surgical procedure (including no gum or hard candy).
What about non-fertility medicines and herbs I take regularly?
We WANT you to take your prescription drugs, with a few sips of water, before leaving home. Please also bring the bottle with you. It is very important that you take drugs such as blood pressure medicine, stomach acid medicine, and asthma medication the morning of your procedure. If you have asthma, bring your inhaler with you. We may have you take a puff or two before we start the anesthetic. . If you take herbs we suggest that you stop immediately. Some of them cause blood clotting problems and others interact with anesthesia drugs and can create a high blood pressure crisis. If you have insulin dependent diabetes be sure your primary nurse is aware so you can be given specific instructions for that day. Please bring your insulin with you and your blood sugar test equipment.
Please leave the following items at home:
- Contact Lenses
- Elastic bands on dental braces
- All jewelry except for your wedding ring. This includes: necklaces, bracelets, rings, earrings, and body piercing jewelry of the lip, tongue, and nose.
Going Home After the Procedure
You must go home from the clinic with a responsible adult. You cannot take a cab by yourself. In the case of couples who are each having an anesthetic, a third person must take you home. Driving should be restricted after your procedure, for the remainder of the day. Driving after anesthesia can be extremely dangerous.
Do not plan on making major decisions or going to work that day. If you go to work you may be acting like you are drunk and you are very likely to make mistakes in judgment.
You can have water as soon as you wake up and you can eat as soon as you get home.
Who will care for me in the recovery room when I’m waking up?
You will actually wake up in the operating room at the end of the procedure and move yourself onto the recovery room bed. So you will be quite awake even before you get to the recovery room. You may not remember that however, because the drugs we use do create a considerable amount of amnesia. The Shady Grove Fertility has full time registered nurses that staff the recovery room seven days a week. All of these nurses are well qualified to care for you.
Will I have pain after the procedure?
Women may experience varying degrees of cramping sensations after retrieval. We will give you analgesic (pain killer) medication, as you need it. Most people need nothing or only two acetaminophen (Tylenol). Men usually have no pain after their procedures because the local anesthetic is still working. Women and men who need a prescription for a stronger analgesic will be given one.
Will I have a tube down my throat?
Very rarely. The tube you are referring to is called an endotracheal tube. We usually do not need to intubate our patients. The procedures are very brief and our patients usually have good airways that do not require artificial devices to keep them open. If medically required, we can use intubation.
What are the risks of the anesthetic?
The chance of a life-threatening complication in healthy patients is about one in a quarter of a million. We keep you lightly anesthetized because that is the perfect level for these procedures. If a problem occurs we can quickly wake you up. If we have to use emergency life support equipment we are well trained and experienced in their use.