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Institutional Policy Changes to Prevent Cardiac Toxicity Associated With Bupivacaine Penile Blockade in Infants

Richard N Yu1, Constance S Houck, Alfonso Casta

  • 1From the *Department of Urology, Boston Children's Hospital, Boston, Massachusetts; and †Department of Anesthesiology, Preoperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.

A & a Case Reports
|June 17, 2016
PubMed

Insights

Dorsal penile nerve blocks with bupivacaine are common for infant penile surgery. A retrospective analysis revealed a high complication rate at our institution, leading to policy changes that have since eliminated these complications.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Surgical Analgesia

Background:

  • Dorsal penile nerve block is a standard analgesic technique for infant penile surgery.
  • Bupivacaine is frequently used due to its efficacy and long duration.
  • Concerns exist regarding rapid systemic absorption of bupivacaine and potential adverse effects.

Observation:

  • A retrospective analysis of medical records was conducted.
  • The incidence of complications from dorsal penile blockade was evaluated at a specific institution.
  • The observed complication rate was 0.075%.

Findings:

  • The complication rate at this institution was significantly higher than previously reported.
  • This elevated incidence prompted a review and revision of institutional policy.
  • The updated policy has successfully eliminated complications associated with penile blocks.

Implications:

  • Institutional policy changes can effectively mitigate risks associated with local anesthetic administration.
  • Careful monitoring and procedural adjustments are crucial for patient safety in pediatric surgery.
  • Further research may explore alternative anesthetic agents or techniques to further enhance safety profiles.

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