Objective: To investigate the feasibility of performing GIFT under spinal anesthesia administered through a thin (27-gauge) needle.
Design: Prospectively studied case series.
Setting: A tertiary care center staffed by a 260 physician multispecialty group.
Patients: Twenty-seven consecutive fertility patients underwent 28 laparoscopic GIFT procedures, electing to receive spinal anesthesia administered through a thin (27-gauge) needle.
Interventions: Laparoscopic GIFT and thin-needle spinal anesthesia.
Main outcome measures: Assessment of anesthetic complications and reproductive outcome.
Results: Satisfactory anesthesia was obtained in 27 of the 28 cases (96%). One patient required additional general anesthesia because of failed spinal anesthesia. All patients were discharged from the hospital on the day of surgery and no postdural headache, persistent back pain, meningitis, or neurological deficit was reported on a 7-day follow-up. Of the 12 clinical pregnancies (43%), 9 ongoing/delivered pregnancies occurred (32%). Six patients had livebirths, and three patients have ongoing second or third trimester pregnancies; there were three spontaneous abortions.
Conclusions: Spinal anesthesia administered through a 27-gauge needle is an attractive option for laparoscopic GIFT. The risk of serious morbidity because of an anesthetic-related complications may be reduced, and the oocytes are not exposed to the potentially deleterious effects of the drugs associated with general anesthesia.