Inguinal funicular block in vasectomy

Vasectomy is performed routinely under local anesthesia without major complications. The most frequently used method is local infiltration analgesia (LIA) of the vas deferens at the site of the resection. During the period of August 1992 - February 1993 all men who were referred for vasectomy at the Frederikssund Hospital were solicited to participate in the study. The analgesic efficacy of inguinal funicular block (FB) with 10 ml carbocaine 1% as a supplement to LIA of the vas deferens was investigated. Pain and discomfort during vasectomy and on the first and third day postoperatively were investigated using a questionnaire. 57 healthy male patients scheduled for legal sterilization were randomized in a double blind manner to receive 10 ml carbocaine 1% in the right or left side and 10 ml isotonic NaCl in the contralateral side the patient thereby serving as his own control. Six patients were excluded for inadequate answers to the questionnaire (5) or reoperation for bleeding (1) which could not be related to administration of analgesia. 42 (82%) of 51 patients had pain during the operation; 39 (76%) on the first day after the operation; and 29 (57%) on the third day postoperatively. The therapeutic effect with active FB as a supplement to LIA in the scrotal skin was 73% (p < 0.0001). There was significantly less intraoperative pain on the side of the active inguinal funicular block (p < 0.0001) but no significant differences were found at the first and third postoperative day (p=1.16-1.19). With active FB on the left side the localization of pain was exclusively scrotal in 14% (3/12) and both abdominal and scrotal in 86% (18/21). With active FB on the right side pain distribution was scrotal in 52% (11/21) and abdominal/scrotal in 48% (10/21). Inguinal funicular block can be recommended as a supplement to the routine use of local infiltration analgesia of the vas deferens.