无针喷射与传统针注射用于行外科取精术男性的局部麻醉。

IVFMD, My Duc Hospital, Ho Chi Minh, Vietnam.

Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam.

Andrology. 2019 Jan;7(1):69-75. doi: 10.1111/andr.12557. Epub 2018 Nov 8.

BACKGROUND

Surgical sperm retrieval, requiring local anesthetic injection, is the most frequent surgical procedure in male infertility. However, needle phobia is common and may contribute to negative experiences or refusal of procedures employing needle injection.

OBJECTIVES

The aim of this study was to compare the acceptability, safety, and efficacy of needle-free jet anesthetic technique (MadaJet) with conventional needle injection for surgical sperm retrievals in patients with azoospermia.

MATERIALS AND METHODS

This single-blind randomized controlled trial (RCT) was included of 59 participants who underwent surgical sperm retrievals. Patients were randomly assigned to the needle-free jet (n = 29) or needle injection (n = 30) groups prior to undergoing the surgery. The primary endpoint was the pain score.

RESULTS

Baseline characteristics were comparable between the two groups. The safety and adverse outcomes were also not statistically significant difference (p > 0.05). The pain score in patients using needle-free jet was significantly lower than that in patients using needle injection (p < 0.05). Patients in MadaJet group had a significantly lower discomfort score during (p < 0.001) and after (p = 0.01) injection than those in the needle injection group. However, there was no significant difference in the fear score (before, during, and after) of MadaJet and needle injection (p = 0.98, p = 0.74, and p = 0.94, respectively). The mean time to onset of anesthesia was much shorter in the MadaJet group as compared with needle injection (10 ± 4 vs. 157.5 ± 71 s, p < 0.001). However, the duration of anesthesia in patients using MadaJet was shorter compared with those using needle injection (44 ± 13 vs. 63 ± 26 min, p < 0.001).

CONCLUSION

In conclusion, for local anesthesia in patients undergoing surgical sperm retrieval, MadaJet produces less pain and discomfort with quicker time to onset and offset of anesthesia compared with conventional needle injection.

背景

手术取精需要局部麻醉注射，是男性不育症最常见的手术程序。然而，针恐惧症很常见，可能导致负面体验或拒绝使用针注射的程序。

目的

本研究旨在比较无针射流麻醉技术（MadaJet）与传统针注射在无精子症患者手术取精中的可接受性、安全性和疗效。

材料和方法

这项单盲随机对照试验（RCT）纳入了 59 名接受手术取精的患者。患者在手术前被随机分配到无针射流（n=29）或针注射（n=30）组。主要终点是疼痛评分。

结果

两组患者的基线特征无统计学差异。安全性和不良结果也无统计学差异（p>0.05）。使用无针射流的患者疼痛评分明显低于使用针注射的患者（p<0.05）。MadaJet 组患者在注射过程中（p<0.001）和注射后（p=0.01）的不适感评分明显低于针注射组，而 MadaJet 组和针注射组的恐惧评分（注射前、注射中和注射后）无统计学差异（p=0.98、p=0.74 和 p=0.94）。与针注射相比，MadaJet 组的麻醉起效时间明显缩短（10±4 与 157.5±71 s，p<0.001）。然而，使用 MadaJet 的患者的麻醉持续时间比使用针注射的患者短（44±13 与 63±26 min，p<0.001）。