Summary of findings for the main comparison. Conscious sedation and analgesia (CSA) compared with CSA+acupuncture for women undergoing oocyte retrieval for assisted reproduction.
| Conscious sedation and analgesia (CSA) compared with CSA+acupuncture for women undergoing oocyte retrieval for assisted reproduction | ||||||
| Patient or population: women undergoing oocyte retrieval for assisted reproduction Setting: assisted reproduction clinic Intervention: conscious sedation and analgesia (CSA) Comparison: CSA + acupuncture | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with CSA + acupuncture |
Risk with CSA only (95% CI) |
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| Intraoperative pain | Mean intraoperative pain score in the comparison group was 4.9 points on a 0 to 10 VAS. | Mean score in the CSA‐only group was 1 point higher (0.18 higher to 1.82 higher) | ‐ | 62 (1 RCT) | ⊕⊝⊝⊝ VERY LOWa,b | |
| Postoperative pain | Mean postoperative pain score in the comparison group was 3.2 on a 0 to 10 VAS. | Mean score in the CSA‐only group was 0.6 points higher (0.1 lower to 1.3 higher) | ‐ | 61 (1 RCT) | ⊕⊝⊝⊝ VERY LOWa,b | |
| Pregnancy | 344 per 1000 | 242 per 1000 (95 to 493) |
OR 0.61 (0.20 to 1.86) |
61 (1 RCT) | ⊕⊝⊝⊝ VERY LOWa,b | |
| Patient satisfaction | No studies reported this outcome. | Not estimable | ‐ | ‐ | ||
| Side effects (postoperative vomiting and/or vomiting) | 156 per 1000 | 233 per 1000 (78 to 521) | OR 1.64 (0.46 to 5.88) | 62 (1 RCT) | ⊕⊝⊝⊝ VERY LOWa,b | |
| Postoperative complications | No studies reported this outcome. | Not estimable | ‐ | ‐ | ||
| *The risk in the intervention group (and its 95% confidence interval) is based on the risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; CSA: conscious sedation and analgesia; OR: odds ratio; VAS: visual analogue scale. | ||||||
| GRADE Working Group grades of evidence. High quality: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded one level for serious risk of bias: unclear risk of bias in one or two domains.
bDowngraded two levels for very serious imprecision: very small sample size and low event rate and/or wide confidence intervals compatible with benefit in either group or no effect.