No-Needle Local Anesthesia for Adult Male Circumcision.
Summary of "No-Needle Local Anesthesia for Adult Male Circumcision."
PURPOSE:
We used a local anesthetic jet injection technique for adult male circumcision. This method eliminates needle use and may decrease the fear of local anesthetic injection used for male circumcision. MATERIALS AND
METHODS:
We recruited 60 men seeking voluntary adult male circumcision into the study from June to September 2009. We used a MadaJet(R) Medical Injector to deliver a high pressure spray of 0.1 ml 2% plain lidocaine solution directly through the penile skin circumferentially around the proximal third of the penis. All men underwent circumcision using the Shang Ring and were evaluated for anesthetic safety, efficacy and acceptability. Pain was measured on a visual analog scale.
RESULTS:
The average volume of 2% lidocaine anesthetic solution delivered by jet injection was 0.1 ml with a mean total of 0.9 ml per circumcision procedure. More than 85% of men did not require supplemental anesthesia. Anesthetic onset required approximately 45 seconds from the time that injections were completed. Mean pain scores for immediate postoperative, 24-hour postoperative, ring removal and post-ring removal events were 0.1, 6.8, 2.2 and 0.9, respectively. In 4 patients (6.67%) mild urethral bleeding resolved with pressure, resulting in technique modification.
CONCLUSIONS:
No-needle jet injection is safe and effective for adult MC. The technique efficiently delivers local anesthesia with rapid onset in men undergoing circumcision. This needle-free approach may enhance the popularity of adult male circumcision.
Affiliation
Department of Sexual Medicine, Yijishan Hospital-Wannan Medical College, Wuhu, People's Republic of China.
Journal Details
This article was published in the following journal.
Name: The Journal of urology
ISSN: 1527-3792
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20643441
- DOI: http://dx.doi.org/10.1016/j.juro.2010.04.080
Medical and Biotech [MESH] Definitions
Dibucaine
A local anesthetic of the amide type now generally used for surface anesthesia. It is one of the most potent and toxic of the long-acting local anesthetics and its parenteral use is restricted to spinal anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1006)
Circumcision, Male
Excision of the prepuce of the penis (FORESKIN) or part of it.
Needle Sharing
Usage of a single needle among two or more people for injecting drugs. Needle sharing is a high-risk behavior for contracting infectious disease.
Tetracaine
A potent local anesthetic of the ester type used for surface and spinal anesthesia.
Anesthesia, Local
A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.
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