Penile Block via the Subpubic Space in 100 Children

Dalens, B; Vanneuville, G; Déchelotte, P.

doi:10.1213/00000539-198907000-00008

Cited by 72 publications

(51 citation statements)

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“…The patients were randomly divided into two groups. After the operation penile block by subpub ic space, reported by Dalens et al [10], was performed under sterile conditions in 16 patients (group 1). The remaining 15 patients did Significance of difference from group 1: * p < 0 .0 5 .…”

Section: Methodsmentioning

confidence: 99%

“…Several anesthetic tech niques have been devised for such patients [3][4][5][6][7][8][9]. Penile block appears to be the most dependable technique be cause it affords great relief from pain by blocking the nerves that supply sensory innervation to the foreskin and glans [3][4][5][6]9], Recently, Dalens et al [10] found that the dorsal nerves of the penis could be safely approached by subpub Received: Februar>' 8,1994 Accepted: April 15. 1994 ic space.…”

Section: Introductionmentioning

confidence: 99%

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Penile Block via Subpubic Space for Children Who Underwent Superficial Operation of the Penis

et al. 1994

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Penile nerve block via the subpubic space was performed to relief the postoperative pain of children who underwent superficial surgery of the penis. Thirty-one male children were subdivided into two groups. After dorsal slit procedure had been carried out under general anesthesia, 16 patients underwent subpubic penile nerve block (group 1), while 15 patients had no additional anesthetic procedure (group 2). Time to the first postoperative pain in group 1 was statistically longer than that in group 2 (p < 0.05). Most patients in group 1 did not require postoperative analgesics during the first 24 h after surgery. This technique appeared to be effective in relieving the postoperative pain of children who underwent superficial operation of the penis.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Penile Block via Subpubic Space for Children Who Underwent Superficial Operation of the Penis

et al. 1994

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“…[1][2][3][4] The analgesic effect of US-guided PNB in adult patients undergoing penile surgery has yet to be demonstrated. We report here its advantages in a randomized, blinded, clinical study.…”

Section: To the Editormentioning

confidence: 99%

Ultrasonography-guided penile block for adult penile surgery

Gürkan

Kuş

Aksu

et al. 2016

Can J Anesth/J Can Anesth

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“…Following intravenous induction of anaesthesia, with the child spontaneously breathing oxygen and isoflurane through a laryngeal mask airway, a dorsal penile nerve block was performed under sterile conditions with a 22-G blunt-bevel needle. The subpubic approach to the dorsal nerves of the penis was used [5], with the child lying in the supine position and the penis pulled inferiorly. Two symmetrical injections 1 cm lateral to the midline, and just below the lower border of the pubis symphysis, were performed.…”

Section: Case Reportmentioning

confidence: 99%

Caudal anaesthesia as a treatment for penile ischaemia following circumcision

Kaplanian¹,

Chambers

Forsyth

2007

Anaesthesia

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SummaryWe report an ischaemic penile glans following circumcision and a dorsal penile nerve block in a 9-year-old boy. Ischaemia of the glans penis is a rare complication associated independently with both circumcision and dorsal penile nerve blocks. There are a number of pathophysiological mechanisms of this ischaemia and its management is varied and not well recorded. We report the successful management of this complication using a caudal epidural block and also discuss technical aspects of penile nerve blocks. Circumcision is a commonly performed surgical procedure with a low complication rate. Penile ischaemia is a rare complication of circumcision and surgical causes include haematoma, vessel ligation, and an excessively tight suture line.The dorsal penile nerve block is a widely used form of regional anaesthesia, particularly in children [1]. It is a simple, easy and effective block that reduces postoperative pain and analgesic requirements. A number of complications have, however, been reported [1][2][3][4]. Ischaemia of the glans penis is a rare complication associated with this block and may arise via a number of mechanisms [3].We report a case of ischaemic glans penis following circumcision and dorsal penile nerve block in a 9-yearold boy which was managed successfully with a caudal block. Case reportA healthy 9-year-old, 38-kg Caucasian boy presented for an elective circumcision. Following intravenous induction of anaesthesia, with the child spontaneously breathing oxygen and isoflurane through a laryngeal mask airway, a dorsal penile nerve block was performed under sterile conditions with a 22-G blunt-bevel needle. The subpubic approach to the dorsal nerves of the penis was used [5], with the child lying in the supine position and the penis pulled inferiorly. Two symmetrical injections 1 cm lateral to the midline, and just below the lower border of the pubis symphysis, were performed. The needle was inserted almost perpendicularly to the skin with slight caudal and medial angulation. After aspiration, to exclude intravenous placement of the needle, 3 ml 0.5% plain bupivacaine was injected on each side. The block appeared uncomplicated. An uneventful classic circumcision was then performed using bipolar diathermy. However, in recovery, the block appeared ineffective and the child required a total of 6 mg morphine to control significant pain. Examination of the penis at this point showed no evidence of bleeding, haematoma or vascular compromise.Four hours later, nursing staff requested urgent surgical and anaesthetic consultations. The boy had ongoing pain and examination revealed a flaccid penis with a significantly ischaemic, poorly perfused, almost black, glans. Significantly, the penile shaft was well perfused and there was no sign of swelling, haematoma or bruising, either at the site of the penile block or at the glans. An urgent duplex Doppler demonstrated good blood flow in both penile arteries distal to the block site. Surgical opinion was that the viability of the glans was threatened but the...

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Penile Block via the Subpubic Space in 100 Children

Cited by 72 publications

References 0 publications

Penile Block via Subpubic Space for Children Who Underwent Superficial Operation of the Penis

Penile Block via Subpubic Space for Children Who Underwent Superficial Operation of the Penis

Ultrasonography-guided penile block for adult penile surgery

Caudal anaesthesia as a treatment for penile ischaemia following circumcision

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