Local Anesthesia Irrigation Technique Reduces Post-Operative Pain Following Vasectomy Reversal
Philip Werthman, Mehran Movassaghi, Dean Berkis, Los Angeles, CA
Presented at the American Urological Association Western Section Meeting 2010
OBJECTIVES: Spermatic cord blocks delivered via needles have increased risks of hematoma or accidental injury to the vas. We evaluated a novel needleless approach in terms of post-operative pain and time spent in recovery in a retrospective manner. Our goal was show improved pain control using this novel method.
METHODS: 31vasectomy reversal patient charts were evaluated in terms of post-operative pain scores, intravenous pain management and time to discharge. Group 1 (n=18) received local anesthetic using our needleless approach while group 2 (n=13) received no local anesthesia.
RESULTS: All Group 1 patients had a starting and ending post-operative pain score of zero and none required any pain medication while in the recovery room. Group 2 patients had an average starting and ending pain scores of 4.8 (range 0-8) and required an average of 25 mcgs of fentanyl (range 0-100 mcgs). Group 1 patients had a significant (p=0.0023) reduction in post-operative pain. The average time spent in recovery was 75 minutes for Group 1 and 80 minutes for Group 2.
CONCLUSIONS: Local anesthetic instillation with marcaine prior to closing the vasectomy reversal incision allows patients to awaken pain-free, alleviates post-operative pain and the need for narcotics in the recovery room. Patients receiving local anesthesia had a slightly shorter recovery room stay than matched controls.