B95 Ultrasound guided spermatic cord block for orchidectomy

Abstract

<h3>Background and Aims</h3> The improved efficacy and safety of Ultrasound guided spermatic cord block( SCB)technique in regional anaesthesia have added advantage for scrotal surgeries over blind technique,neuraxial , general anaesthesia . Real time visualisation of spermatic cord ,blood vessels ,vasdeference avoids complications,accurate local anaesthetic(LA) disposition provides anaesthesia for testicular surgeries.Apart from the benefits of simple,safe technique ,it provides high success rate ,effective post-operative analgesia ,greater patient satisfaction. The aim of the study was to report efficacy of ultrasound guided SCB in 12 cases(male patients, age 55- 80 years ,ASA II-III) undergoing bilateral orchidectomy . <h3>Methods</h3> The present study included 12 consecutive patients undergoing bilateral orchidectomy under ultrasound guided SCB.A linear array transducer used to identify spermatic cord,vas deference, testicular artery with colour doppler, 10 mlLA (5 ml 2%lignocaine + 5 ml 0.5%bupivacaine) deposited aroundeach side spermatic cord using 22G hypodermic needle advancing lateral to medial direction. Pudendal nerves blocked by LA infiltration at scrotal incision site .The primary outcome was to access the success rate,and secondary outcome were to monitor hemodynamic parameters ,cord haematoma, other complications, postoperative VAS, rescue analgesia if needed <h3>Results</h3> In this case study 12 patients ,24 blocks were performed with success rate of 91.6% (n=22), requiring analgesia supplemention 8.3%( n= 2) , postoperative analgesia lasted for average duration for 12 hours. No patients were converted to general anaesthesia <h3>Conclusions</h3> The ultrasound guided spermatic cord block offers an easy, safe technique ,good post operative analgesia, avoiding complications of general anaesthesia, can be considered a better option for elderly patients minimizing the hospital stay.