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Circumcision supplemented by dorsal penile nerve block with 0.75% ropivacaine: a complication
D Burke1, V Joypaul, M F Thomson
1Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee, Scotland.
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.