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Case Reports
Circumcision Supplemented by Dorsal Penile Nerve Block With 0.75% Ropivacaine: A Complication
  1. Daniel Burke, F.R.C.A.,
  2. Vikram Joypaul, F.R.C.S. and
  3. Melvyn Fyffe Thomson, F.F.A.R.C.S.I.
  1. From the Departments of Anaesthesia and Surgery, Ninewells Hospital and Medical School, Dundee, Scotland.
  1. Reprint requests: Daniel Burke, F.R.C.A., Departments of Anaesthesia and Surgery, Ninewells Hospital and Medical School, Dundee, Scotland DD1 9SY.

Abstract

Background and Objectives Dorsal penile nerve block is a common procedure and can provide effective analgesia after penile surgery. Ischemic complications are rare and generally result from trauma or inadvertent administration of vasoconstrictive solutions.

Case Report We describe a period of temporary ischemia of the glans penis occurring 40 minutes after dorsal penile nerve block with 0.75% ropivacaine. This was successfully treated with an intravenous infusion of iloprost (a PGI2 analogue), and at 43 hours appearances were normal.

Conclusion Theoretical concerns over the vasoconstrictive properties of ropivacaine may be sufficient to avoid its use where the potential for ischemia to end organs is present.

  • Ropivacaine
  • Dorsal penile nerve block

https://doi.org/10.1053/rapm.2000.7594

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