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Case Report
A Complication Associated with Dorsal Penile Nerve Block
  1. Richard Berens, M.D.* and
  2. Stephen P. Pontus Jr., M.D.†
  1. From the Department of Anesthesiology, The Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, Wisconsin
  2. *Fellow, Section of Pediatric Anesthesia
  3. †Assistant Professor of Anesthesiology and Pediatrics, Anesthesiologist and Associate Director, PICU

Abstract

A case describing a 2-day-old term male infant who received a dorsal penile nerve block (DNPB) prior to circumcision, inadvertently with 1:1000 epinephrine, is presented. The patient had a brief hemodynamic response followed by profound vasoconstriction and ischemia of the genitalia. A caudal catheter was inserted and a sympathetic block established in an attempt to antagonize the epinephrine-induced vasoconstriction. The patient's condition improved and no residual effects of the ischemia were noted. A review of complications associated with DNPB and of epinephrine-induced penile ischemia is briefly discussed.

  • Neonatal circumcision complication
  • medication error
  • caudal epidural anesthesia
  • penile ischemia

https://doi.org/10.1136/rapm-00115550-199015060-00008

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