Epinephrine Injection Associated Scrotal Skin Necrosis

Area of Science:

• Urology
• Surgical Complications
• Anesthesiology

Background:

• Male circumcision is a historically common surgical procedure.
• While generally minor, it carries risks of complications, including those related to anesthesia.
• Complications can range from mild to severe, impacting patient outcomes.

Purpose of the Study:

• To report two cases of scrotal skin necrosis.
• To highlight potential complications of lidocaine with epinephrine injection for circumcision anesthesia.
• To inform surgical and anesthetic practices for male circumcision.

Main Methods:

• Case report of two patients undergoing male circumcision.
• Lidocaine with epinephrine administered via subcutaneous ring block prior to the procedure.
• Observation and documentation of post-operative complications.

Main Results:

• Two patients developed scrotal skin necrosis post-circumcision.
• Necrosis occurred after the use of lidocaine with epinephrine via subcutaneous ring block.
• The complication was directly linked to the anesthetic technique used.

Conclusions:

• Lidocaine with epinephrine injection for subcutaneous ring block anesthesia in male circumcision can lead to scrotal skin necrosis.
• Careful consideration of anesthetic agents and techniques is crucial to minimize risks.
• Awareness of this specific complication is important for urologists and anesthesiologists.