ISSN 2398-2942      

Local anesthesia: intratesticular

icanis
Contributor(s):

Rebecca Bhalla

Jo Murrell

Synonym(s): Intratesticular block


Introduction

  • Locoregional anesthetic techniques involve the use of local anesthetic to desensitize nerves.
  • Local anesthetic injected appropriately near peripheral sensory nerves stops transmission of noxious impulses to the spinal cord and brain.
  • Compared to other local anesthetics, lidocaine has a short onset of action (up to 5 mins) and a shorter duration of action (approximately 60 mins). Using lidocaine in a technique means that surgery can be started within minutes.
  • Intratesticular injection of a local anesthetic is a type of infiltration block, whereby local anesthetic is injected into the surgical area, as opposed to aiming for a target nerve.
  • Injection of intratesticular lidocaine diffuses to the spermatic cord where the nerves of the testicular plexus, containing visceral afferent fibers, are situated. The superficial perineal nerve (a division of the pudendal nerve) supplies sensory innervation to the scrotum.
  • Intratesticular lidocaine has been shown to reduce the sympathetic response to surgery in dogs and cats, and to decrease isoflurane requirements in dogs.

Uses

Advantages

  • It reduces or abolishes the sympathetic response to noxious stimulus of surgery.
  • It may provide postoperative comfort (dependent on surgical time).

Disadvantages

  • Failure of the block can lead to a sympathetic response to surgery.
  • Local anesthetic toxicity can occur when there is a high plasma concentration of local anesthetic Local anesthesia: overview. This leads to cardiovascular and neurological complications. Therefore, avoidance of intravascular injection, and using a dose within the recommended range is advised.

Requirements

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Preparation

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Procedure

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Aftercare

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Huuskonen V, Hughes J M, Estaca Bañon E et al (2013) Intratesticular lidocaine reduces the response to surgical castration in dogs. Vet Anaesth Analg 40 (1), 74-82 PubMed.
  • McMillan M W, Seymour C J, Brearley J C et al (2012) Effect of intratesticular lidocaine on isoflurane requirements in dogs undergoing routine castration. JSAP 53 (7), 393-397 PubMed.

Other sources of information

  • Hermanson J W, de Lahunta A, Evans H E (2019) Miller’s Anatomy of the Dog. (5th edn) St Louis, Missouri: Elsevier.
  • Duke-Novakovski T (2016) Pain management II: local and regional anaesthetic techniques. In: Duke-Novakovski T, de Vries M, Seymour C (eds) BSAVA Manual of Canine and Feline Anaesthesia and Analgesia (3rd edn) Gloucester, UK: British Small Animal Veterinary Association. p 146.

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