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

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. (C) 2008 Elsevier Inc. All rights reserved.