Circumcision supplemented by dorsal penile nerve block with 0.75% ropivacaine: a complication.
OBJECTIVE
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.


METHODS
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.


CONCLUSIONS
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.
Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee, Scotland.
D
D
Burke
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V
Joypaul
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MF
Thomson
D000293:Adolescent; D000577:Amides / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D002944:Circumcision, Male / Q000009:adverse effects*; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008297:Male; D009407:Nerve Block / Q000009:adverse effects*; D010413:Penis / Q000098:blood supply; D012039:Regional Blood Flow; D000077212:Ropivacaine
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine