A complication associated with dorsal penile nerve block

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.