Comparison of Spinal Anesthesia and Spermatic Cord Block for Bilateral Orchiectomy

Sanpasitthiprasong Hospital

Status: Invitation-only

Conditions: Orchiectomy; Pain Score; Spermatic Cord Block; Spinal Anesthesia; Prostate Cancer

Treatments: Procedure: bilateral orchiectomy

Study type: Interventional

Funder types: Other

Identifiers

NCT06313775

SPS005

Details and patient eligibility

About

The goal of this randomized controlled trial is to compare intraoperative pain score, Morphine consumption during 6 and 12 hour after surgery, and postoperative complications between SA and SCB groups in metastatic prostate cancer patient. The main question it aims to answer are:

• Is there a difference in the level of pain during bilateral orchiectomy between spinal anesthesia and spermatic cord block?

Participants will undergo bilateral orchidectomy. They will be randomly assigned to two groups: the group receiving spinal anesthesia and the group receiving spermatic cord block If there is a comparison group: Researchers will compare intraoperative pain score, Morphine consumption during 6 and 12 hour after surgery, and postoperative complications in both groups of patients.

Full description

Objective : To compare intraoperative pain score, Morphine consumption during 6 and 12 hour after surgery, and postoperative complications between SA and SCB groups.

Material and Method : This Randomized Controlled Trial that collected data from prostate cancer patients who underwent orchiectomy in our institution. Patients were randomly divided into two groups; SA and SCB. Data was collected on intraoperative pain score, 1 hour post-surgery, Morphine consumption during 6 and 12 hour after surgery and complications. All data was statistically analyzed using Independent t-test and Fisher's exact test.

Inclusion criteria : Patients of all ages diagnosed with prostate cancer undergoing treatment with bilateral orchiectomy.

Exclusion criteria :

1. Patients with a history of Xylocaine allergy.

2. Patients with uncorrected bleeding disorders.

3. Patients with paralysis or neurosensory deficits

4. Patients with dementia or cerebrovascular accidents (strokes) that impair communication.

5. Patients with contraindications for spinal anesthesia, including:

   • Patient refusal of spinal anesthesia.
   • Infection at the site of spinal injection.
   • Allergy to specific types of local anesthetics, such as Hyperbaric bupivacaine.
   • Inability of the patient to cooperate with the spinal anesthetic procedure.
   • Suspicion of high intracranial pressure based on abnormal physical examination.
   • Aortic stenosis with fixed cardiac output.
   • Low platelet count.

Enrollment: 18 estimated patients

Sex: Male

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients of all ages diagnosed with prostate cancer undergoing treatment with bilateral orchiectomy

Exclusion criteria

1. Patients with a history of Xylocaine allergy.

2. Patients with uncorrected bleeding disorders.

3. Patients with paralysis or neurosensory deficits

4. Patients with dementia or cerebrovascular accidents (strokes) that impair communication.

5. Patients with contraindications for epidural anesthesia, including:

   • Patient refusal of spinal anesthesia.
   • Infection at the site of spinal injection.
   • Allergy to specific types of local anesthetics, such as Hyperbaric bupivacaine.
   • Inability of the patient to cooperate with the spinal anethetic procedure.
   • Suspicion of high intracranial pressure based on abnormal physical examination.
   • Aortic stenosis with fixed cardiac output.
   • Low platelet count.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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18 participants in 2 patient groups

Spinal anesthesia

Active Comparator group

Description:

spinal anesthesia : 0.5%hyperbaric bupivacaine 10-15 mg/dose injected at L3-L5

Treatment:

Procedure: bilateral orchiectomy

spermatic cord block

Experimental group

Description:

1%Xylocaine with adrenaline (Max 7 mg/kg/dose) divided to inject into each side of the spermatic cord 6-8 ml and infiltration into the scrotal incision area 3-4 ml.

Treatment:

Procedure: bilateral orchiectomy