ORIGINAL ARTICLE
Year : 2013  |  Volume : 6  |  Issue : 2  |  Page : 153-157

Spermatic cord block with ketamine as an adjuvant to bupivacaine improves postoperative analgesia for testicular sperm extraction surgery


1 Anaesthesiology, ICU & Pain Relief Department, National Cancer Institute, Cairo University, Cairo, Egypt
2 Andrology Department, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt; Andrology Department, Samir Abbas Infertility Centre, Al Khobar, Kingdom of Saudi Arabia

Correspondence Address:
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.ASJA.0000428175.37589.ee

Rights and Permissions

Purpose

To compare the postoperative analgesic effect of bupivacaine 0.5% plus ketamine 20 mg and bupivacaine 0.5% alone in alleviating testicular visceral pain when it is injected for spermatic cord block in testicular sperm extraction (TESE) surgery.

Patients and methods

A randomized, double-blind, controlled trial study including 50 American Society of Anesthesiologists I–II patients undergoing TESE surgery was performed under general anaesthesia. At the end of surgery, patients were allocated randomly to one of two groups: the ‘K’ group (n=25) received bupivacaine 0.5% plus ketamine 20 mg and the ‘B’ group (n=25) received bupivacaine 0.5% alone in a total volume of 10 ml for spermatic cord block. Postoperative pain was assessed by measurement of pain-free time, which was defined as the time from regaining consciousness to the appearance of mild spontaneous testicular pain. Also, the visual analogue scale (VAS) score at 6, 9, 12 and 24 h being at rest was measured. The frequency of analgesic intake in the first 24 h was also determined and the incidence of postoperative nausea and vomiting (PONV) was recorded.

Results

The mean pain-free time was significantly higher in the K group than the B group [302 (48) vs. 225 (27) min, P=0.000]. The mean VAS score was significantly lower at 9 h postoperatively in the K group compared with the B group (P=0.017). Although the mean VAS scores were lower at 6, 12 and 24 h in the K group, there were no statistically significant differences between the groups (P=0.1, 0.186 and 0.086, respectively). Differences in the frequency of analgesic intake between the two groups were not statistically significant. There was no statistically significant difference between the groups in PONV.

Conclusion

The addition of ketamine (20 mg) as an adjuvant to bupivacaine for spermatic cord block is a good option for postoperative pain control as it prolongs pain-free time and lowers VAS scores after TESE surgery, with no added risk of PONV.



[PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1064    
    Printed45    
    Emailed0    
    PDF Downloaded206    
    Comments [Add]    

Recommend this journal