Comparative analysis of pain during anesthesia and no-scalpel vasectomy procedure among three different local anesthetic techniques.
OBJECTIVE
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).


CONCLUSIONS
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.
Division of Urology, Creighton University Medical Center, Omaha, Nebraska, USA. himanshu.aggarwal@duke.eduSubmitted
Himanshu
H
Aggarwal
Rei K
RK
Chiou
Larry E
LE
Siref
Stewart E
SE
Sloan
D000328:Adult; D000772:Anesthesia, Local / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D014659:Vasectomy / Q000009:adverse effects* / Q000379:methods