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Dorsal penile nerve block complicated by local anaesthetic systemic toxicity

Claris Oh1, Ned Kinnear1,2, Jason Lee1

  • 1Department of Urology, Flinders Medical Centre, Adelaide, Australia.

Urology Case Reports
|January 15, 2025
PubMed

Keywords:
LidocaineLipid emulsionLocal anaestheticPenile blockSystemic toxicity

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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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