Local or spinal anesthesia in subinguinal varicocelectomy: a prospective randomized trial

To determine whether local anesthesia (LA) is an acceptable alternative to spinal anesthesia (SA) for varicocelectomy.

A total of 60 men with varicocele were included in the present study. The evaluation of pain during and after surgery was determined using the visual analog scale. The secondary outcome measures of the present study were the interval to the first postoperative analgesic requirement, total analgesic consumption, and the incidence of side effects.

The mean postoperative visual analog scale score was 2.56 ± 1.85 for the SA group and 2.77 ± 1.94 for the LA group (P = .659). Patients in the SA group experienced significantly less pain during surgery than those in the LA group (P = .017). However, the pain scores between the 2 groups did not differ significantly at 2, 4, 6, 8, 12, or 24 hours after surgery. In addition, a positive correlation was found between the duration of symptoms and the visual analog scale score at 24 hours postoperatively. The mean dosage of injected diclofenac was 46.5 ± 23.3 mg and 32 ± 28.15 mg in the SA and LA groups, respectively (P = .018). The SA group developed more postoperative complications, such as urinary retention, postspinal backache, headache, hypotension, and delayed mobilization, in the postoperative period.

LA is an effective, reliable, reproducible, simple, and safe alternative anesthetic method for subinguinal varicocelectomy.