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Related Experiment Videos

A complication associated with dorsal penile nerve block.

R Berens1, S P Pontus

  • 1Department of Anesthesiology, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee 53201.

Regional Anesthesia
|November 1, 1990
PubMed
Summary

A penile nerve block with epinephrine caused severe vasoconstriction in an infant. A sympathetic block successfully reversed the effects, preventing lasting damage.

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Area of Science:

  • Pediatric Anesthesiology
  • Neonatal Surgery
  • Pharmacology

Background:

  • Dorsal penile nerve block (DNPB) is a common procedure for neonatal circumcision.
  • Accidental administration of epinephrine in DNPB can lead to adverse effects.
  • Epinephrine causes vasoconstriction, potentially compromising tissue perfusion.

Observation:

  • A 2-day-old infant received a DNPB with inadvertent epinephrine (1:1000).
  • The infant experienced transient hemodynamic changes followed by severe penile vasoconstriction and ischemia.
  • A caudal catheter was used to administer a sympathetic block.

Findings:

  • The sympathetic block effectively antagonized the epinephrine-induced vasoconstriction.
  • The infant's condition improved with no residual ischemic effects.
  • This case highlights the risks of epinephrine in DNPB and the utility of sympathetic blockade.

Implications:

  • Caution is advised when preparing DNPB solutions to prevent epinephrine contamination.
  • Prompt recognition and management of epinephrine-induced penile ischemia are crucial.
  • Sympathetic blockade can be a viable treatment for managing severe vasoconstriction in this context.

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