Comparative Analysis of Pain During Anesthesia and No-scalpel Vasectomy Procedure Among Three Different Local Anesthetic Techniques
Received 5 October 2008; accepted 15 November 2008. published online 11 May 2009.
Objectives
To compare the pain during anesthesia and during the no-scalpel vasectomy procedure for local infiltration anesthesia (LIA), LIA supplemented with spermatic cord block (LIA + SCB), and no needle jet anesthesia.
Methods
Bilateral no-scalpel vasectomy was performed in 323 patients during 2007. Of the 323 patients, 65 received LIA, 29 received LIA + SCB, and 227 received anesthesia using the no-needle technique with the MadaJet device. The level of pain during anesthesia administration and the subsequent procedural pain was documented for each technique using a pain scale of 0-10.
Results
Pain during the LIA + SCB procedure (mean 1.7 ± 1.6) was significantly less than the pain during LIA (mean 3.3 ± 2.3; P < .01). No statistically significant difference was found between the levels of pain experienced during LIA + SCB and no-needle jet anesthesia (P >> .01 and P >> .05, respectively). Intraoperative pain after LIA + SCB (mean 0.64 ± 1.2) was significantly less than the intraoperative pain after LIA (mean 2.7 ± 2.6; P <<< .01). Also, the intraoperative pain after LIA + SCB was significantly less than the intraoperative pain after no-needle jet anesthesia (mean 2.13 ± 2.0; P <<< .01).
Conclusion
LIA + SCB is an effective and better method of anesthesia compared with LIA alone or no-needle jet anesthesia for reducing the pain during vasectomy. Also, no difference was found in the pain levels during anesthesia for the LIA + SCB, LIA, and no-needle anesthesia techniques.
aDivision of Urology, Creighton University Medical Center, Omaha, Nebraska
bDivision of Urology, University of Nebraska Medical Center, Omaha, Nebraska
cDivision of Urology, Department of Veterans Affairs, Omaha, Nebraska
dWestern Iowa Healthcare System, Midwest Urology Associates and Urology Specialists, Immanuel Plaza West, Omaha, Nebraska
Reprint requests: Himanshu Aggarwal, M.D., Department of Surgery, Duke University Medical Center, 405 Dovershire Parkway, Durham, NC 27704
ABSTRACT