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Comparative analysis of effectiveness of two local anesthetic techniques in men undergoing no-scalpel vasectomy.

White MA, Maatman TJ

Michigan State University College of Osteopathic Medicine Urologic Consortium, Grand Rapids, Michigan, USA.

OBJECTIVES: To compare the effectiveness of two local anesthetic techniques in men undergoing no-scalpel vasectomy. METHODS: Before undergoing no-scalpel vasectomy, 50 men underwent separate forms of anesthesia to each side of their scrotum. One vas deferens was anesthetized with a high-pressure spray of 0.3 mL 2% lidocaine using the MadaJet Medical Injector, and the other vas deferens was anesthetized using the traditional vasal block performed with three 1.7-mL ampules of mepivacaine using a 27-gauge needle. The pain of the initial delivery of anesthesia and the pain with the subsequent vasectomy were recorded. RESULTS: Fifty men underwent no-scalpel vasectomy with a different anesthetic delivery system to each vas deferens separately. A statistically significant reduction was noted in the visual analog pain scores in favor of no-needle administration of anesthesia, 1.56 of 10 versus 2.12 of 10 (P <0.029). A reduction was noted in the visual analog pain score for the subsequent vasectomy after administration of anesthesia using the no-needle method, but this was not statistically significant (1.68 of 10 versus 1.86 of 10; P <0.66). CONCLUSIONS: No-needle anesthesia with jet injection reduced the pain associated with traditional delivery of anesthesia to the skin and vas deferens before no-scalpel vasectomy. Additional studies are needed with more subjects to evaluate whether the decrease in procedural pain is statistically significant when comparing the two types of anesthetics.

Published 25 December 2007 in Urology, 70(6): 1187-9.
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