Spermatic Cord Block
Conditions
Keywords
Spermatic Cord Block, Magnesium Sulfate, Dexmedetomidine
Brief summary
Using the spermatic cord block has been of great advantage, as it has been cost saving, efficient technique whether used inon its own or combination with a sedative or . Furthermore, it provides minimal cardiac risks, early case ambulation, satisfactory postoperative pain control, as well as a reduced hospital stay and cost. one of the major drawbacks of spermatic cord block is being a single injection technique, leading to a short postoperative analgesia duration. So, to overcome this flaw some adjuvants were proven to prolong the analgesia duration as Dexmetedomidine (Dex), and magnesium.
Detailed description
The technique of the spermatic cord block was first described in the 1960s by Earle AS.Using the spermatic cord block has been of great advantage, as it has been cost saving, efficient technique whether used inon its own or combination with a sedative or . Furthermore, it provides minimal cardiac risks, early case ambulation, satisfactory postoperative pain control, as well as a reduced hospital stay and cost. one of the major drawbacks of spermatic cord block is being a single injection technique, leading to a short postoperative analgesia duration. So, to overcome this flaw some adjuvants were proven to prolong the analgesia duration as Dexmetedomidine (Dex), and magnesium.
Interventions
DRUGControl Test
Spermatic cord block by18ml levobupivacaine 0.5% plus 2 ml normal saline in total volume of 20 ml. The procedure is repeated on the contralateral side.
DRUGDexmedetomidine
Spermatic cord block by total of 18ml levobupivacaine 0.5% plus 1 μg/kg dexmedetomidine in 2 ml in total volume of 20 ml The procedure is repeated on the contralateral side.
Spermatic cord block by total of 18ml levobupivacaine 0.5% plus 1 μg/kg dexmedetomidine and 100 mg magnesium sulphate in 2 ml in total volume of 20 ml . The procedure is repeated on the contralateral side.
DRUGmagnesium sulphate
Spermatic cord block by total of 18ml levobupivacaine 0.5% plus 100 mg magnesium sulphate in 2 ml in total volume of 20 ml
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Masking description
Prospective randomized double blinded clinical study on humans
Intervention model description
Following skin sterilization and local anesthetic infiltration of the superficial tissues, an echogenic 22-G block needle is inserted in-plane to the ultrasound beam in a cranial-to-caudal direction the spermatic cord in short axis and directed towards the deferent duct, contralateral to the testicular artery. The needle tip was advanced to become contact with the deferent. Correct location of the needle tip was confirmed by injecting 0.5-1 ml to see the local anesthetic spreading around the deferent duct. A total of 18ml levobupivacaine 0.5% are then injected into the spermatic cord block . The procedure is repeated on the contralateral side.
Eligibility
Sex/Gender
MALE
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients aged from 18 to 60 years. * ASA I-II. * Undergoing Testicular Sperm Extraction Surgery. * BMI from 18.5 to 30 kg/m2
Exclusion criteria
* Patient refusal * Contraindications to regional anesthesia (bleeding disorders e.g. INR\>1.5, PC\<70%, platelet count\<100 × 109, use of any anti-coagulants, local infection, etc.). * Known allergy to local anesthetics. * ASA III-IV. * Patients aged less than 18 or more than 60. * Body mass index \>35. * Patients with difficulty in evaluating their level of pain.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time from injection of LA to the first postoperative analgesic request | UP TO 1 HOURE | (duration of the block). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| VAS | up to 24 hours | 0 No Pain 1-3 Mild Pain (nagging, annoying, interfering little with ADLs) 4-6 Moderate Pain (interferes significantly with ADLs) 7-10 Severe Pain (disabling; unable to perform ADLs) |
| perform SCAB | UP TO 1 HOURE | The mean time needed to perform SCAB |
| heart rate | up to 24 hours | beat/min |
| Incidence of complications | up to 24 hours | complications |
| mean arterial blood pressure | up to 24 hours | mmHg |
| total nalbuphine consumption | up to 24 hours | total nalbuphine consumption |
Countries
Egypt
Outcome results
None listed