addition of clonidine or fentanyl to lidocaine in local anaesthetic technique for testicular sperm extraction [TESE] a comparative study

ABSTRACT

A group of forty-five ASA I or II patients scheduled for testicular sperm extraction under local analgesia and sedation were studied. In order to improve the efficacy of local anaesthetic drug and better postoperative pain control, clonidine or fentanyl were added to lidocaine. The patients were randomly allocated into three equal groups. All patients received I.V midazolam and pethidine for sedation and glycopyrrolate premedication. In control group, lidocaine was used alone for local technique, however clonidine was added to lidocaine in the second group and fentanyl was added to lidocaine in the third group. Pulse and blood pressure were determined. Sedation and postoperative analgesia were assessed by subjective scoring. All groups showed haemodynamic stability. The mean sedation score was significantly higher in clonidine and fentanyl groups, the postoperative pain intensity and analgesic requirements were significantly less in clonidine group than in control and fentanyl groups. These results confirm that adding clonidine to lidocaine provides an effective safe analgesia for TESE with better postoperative analgesia and early ambulation