Ultrasound guided spermatic cord block for scrotal surgery

Abstract

Editor's key points † Spermatic cord block for scrotal surgery can be an alternative to neuraxial and general anaesthesia and provides long-lasting postoperative analgesia; however, major limitations of the conventional anatomical landmark-based blind injection technique limit its use. † This study showed that a new ultrasound-guided technique for spermatic cord block is feasible and has a high success rate.Background. Performing spermatic cord block for scrotal surgery avoids the potential risks of neuraxial and general anaesthesia and provides long-lasting postoperative analgesia. A blindly performed block is often inefficient and bears its own potential risks (intravascular injection of local anaesthetics, haematoma formation and perforation of the deferent duct). The use of ultrasound may help to overcome these disadvantages. The aim of this study was to test the feasibility and monitor the success rate of a new ultrasoundguided spermatic cord block.

Spermatic Cord Anesthesia Block: An Old Technique Re-imaged

“…Both Kaye and Cassady describe a technique involving three needle passes at slightly different angles to the SC with total deposition of 12–15ml of local anesthetic 2,4. Subsequent articles have commented on the difficulty in palpating and identifying the pubic tubercle,9 especially in patients with protuberant abdomens or large pannus folds. These case reports and studies involving SCAB have primarily been published in the urology and anesthesia literature.…”

“…Additionally, patients require less post-operative pain control as the block serves as its own anesthetic resulting in an overall cost savings for the technique compared with general anesthesia 5. Reported complications of the blind injection technique include vascular injury to the testicular artery6 or possible intra-arterial injection and/or damage to the deferent ducts 9. As the availability of ultrasound (US) for emergency physicians continues to increase, SCAB under ultrasound (US) guidance is a simple technique that can provide immediate anesthesia for patients with testicular and scrotal pain.…”