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    Verbal anesthesia: How it’s used in urologic procedures

    ‘Conversational distraction’ offers clinical, efficiency benefits to patients and physicians


    Meanwhile, the more the verbal anesthetist can personalize the conversation, the more likely the patient can be effectively distracted throughout the procedure and the need for physician coaching comments reduced. Everyone in the treatment room strives to maintain a calm and peaceful environment. The aim of this standardized approach is to reduce the likelihood of surprises to the patient during the procedure. It is our experience that a well-informed and artfully distracted patient tolerates outpatient procedures better, with less anxiety and discomfort.

    Read: Management of the patient requesting transgender surgery

    While VA is poorly defined and not well studied in the literature, it has become an essential adjunct in achieving patient tolerability among dentists and oral surgeons, dermatologists performing Mohs surgery, plastic and reconstructive surgeons using in-office liposuction and laser techniques, ENTs opening sinuses with balloons, ophthalmologists performing LASIK surgery, and gynecologists conducting hysteroscopy and uterine ablations. Most proceduralists, including urologists, have begun to adopt VA to some limited degree with widespread, albeit anecdotal, success.


    VA is a simple technique of saying the right thing at the right time while avoiding words and phrases that evoke anxiety, thus creating a relaxed procedural environment by focusing a patient’s attention away from anxiety-producing stimuli and onto something more familiar. By employing VA for in-office procedures, almost any office procedure can be accomplished without adding safety concerns associated with adjunctive medications (Patient Prefer Adherence 2016; 10:147-52); “Step by step guide to-verbal-anesthesia,” LondonVision Clinic 2009 [http://bit.ly/2q0mtOC]). In the end, we believe that VA can be a helpful addition to the overall experience for patients undergoing local anesthetic urologic procedures.

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    • [email protected]
      Good Morning: I'm curious as to whether more urologists are using male nurses in their practice as most urology patients are male. Having a male nurse along with male verbal anesthetists rather than a females for an intimate procedure would lend itself to making many male patients more comfortable as many men, are not comfortable being so intimately exposed in front of a woman other then their wife, but they won't say so because they don't want to be seen as being weak. It's a known fact male patients won't speak up for fear of being seen as weak and being mocked as such by the medical community. Having all males in the treatment room would also lend itself to making it easier for the male verbal anesthetist to strike up and keep a conversation going longer with his male patient whereby better keeping the patient's mind off of what's going on in the room. Verbal anesthesia has potential if it's used in conjunction with asking a patient are they comfortable with female staff being in the room and if not replacing the female staff with male staff. Verbal anesthesia on a male patient who is not comfortable to begin with being so intimately exposed in front of female staff won't mean a hill of beans to the him which in turn won't help his outcome. Regards, Raffie
    • UBM User
      I particularly found this article interesting in that I have been using this method for over 25 years. Although anecdotal, this method was extremely successful. A number of patients commented how the procedure done was not nearly as uncomfortable as they expected. There is no control group, randomization, or longitudinal aspect to this, none the less, it is nice to see an article on my method of additional anesthesia used during my entire career.


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