D Burke1, V Joypaul, M F Thomson. 1. Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee, Scotland.
Abstract
BACKGROUND AND OBJECTIVES: Dorsal penile nerve block is a common procedure and can provide effective analgesia after penile surgery. Ischemic complications are rare and generally result from trauma or inadvertent administration of vasoconstrictive solutions. CASE REPORT: We describe a period of temporary ischemia of the glans penis occurring 40 minutes after dorsal penile nerve block with 0.75% ropivacaine. This was successfully treated with an intravenous infusion of iloprost (a PGI2 analogue), and at 43 hours appearances were normal. CONCLUSION: Theoretical concerns over the vasoconstrictive properties of ropivacaine may be sufficient to avoid its use where the potential for ischemia to end organs is present.
BACKGROUND AND OBJECTIVES:Dorsal penile nerve block is a common procedure and can provide effective analgesia after penile surgery. Ischemic complications are rare and generally result from trauma or inadvertent administration of vasoconstrictive solutions. CASE REPORT: We describe a period of temporary ischemia of the glans penis occurring 40 minutes after dorsal penile nerve block with 0.75% ropivacaine. This was successfully treated with an intravenous infusion of iloprost (a PGI2 analogue), and at 43 hours appearances were normal. CONCLUSION: Theoretical concerns over the vasoconstrictive properties of ropivacaine may be sufficient to avoid its use where the potential for ischemia to end organs is present.