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Mini-needle lidocaine injections curb vasectomy pain

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – During a no-scalpel vasectomy, lidocaine given via a short fine needle provides excellent anesthesia, Canadian and US researchers report in the May issue of the Journal of Urology.

Vasectomy is one of the most frequent urological surgical interventions performed in men, senior author Dr Michel Labrecque of Laval University in Quebec City told Reuters Health by email.

“Vasectomy can be achieved with essentially no pain or a minor discomfort with a jet gun injector (known as the no-needle anesthesia for vasectomy) but this technique requires specific and costly equipment,” Dr. Labrecque said.

He added, “Our study showed that painless vasectomy can also be achieved in most men using material readily available everywhere, namely a 3 cc syringe and a mini #30 gauge needle which is the size of a hair.”

Dr. Labrecque prospectively tested the method in 277 men. In each case, via a 1-inch needle, he delivered approximately 2 mL of 3% lidocaine without epinephrine directly to the vas at the expected surgical site on each side.

Prior to the procedure, patients expected their pain to be a mean of 3.1 on a 10 cm visual analogue scale. However, they recorded mean scores of 1.5 during anesthesia and 0.6 during the procedure.

“Since the 30 gauge needle technique does not require extra equipment and it is done with a small volume of anesthesia, it may be particularly suitable in low resource settings and may make vasectomy even more attractive and cost-effective,” Dr. Labrecque and his coauthors conclude.

J Urol 2010;183:1959-1963.