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Needle‐free jet versus conventional needle injection for local anesthesia in men undergoing surgical sperm retrieval
Author(s) -
Khoa L. D.,
Quang T. N.,
Toan P. D.,
Loc N. M. T.,
Diem N. T. N.,
Dang V. Q.,
Vu H. N. A.,
Mol B. W.,
Handelsman D. J.
Publication year - 2019
Publication title -
andrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.947
H-Index - 43
eISSN - 2047-2927
pISSN - 2047-2919
DOI - 10.1111/andr.12557
Subject(s) - sperm retrieval , jet (fluid) , medicine , sperm , anesthesia , surgery , male infertility , andrology , mechanics , biology , physics , infertility , pregnancy , genetics
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.