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Dorsal Penile Nerve Block

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1. Ultrasound-guided dorsal penile nerve block vs neurostimulator-guided pudendal nerve block in children undergoing hypospadias surgery: A prospective, randomized, double-blinded trial. (Abstract)

Ultrasound-guided dorsal penile nerve block vs neurostimulator-guided pudendal nerve block in children undergoing hypospadias surgery: A prospective, randomized, double-blinded trial. Hypospadias is a common congenital malformation in pediatric patients. Surgical repair of this malformation is a painful procedure and has long-term effects. Pudendal and penile nerve blocks are commonly preferred techniques for maintaining postoperative analgesia. However, the conventional landmark-based penile (...) block technique involves numerous potential complications and provides a shorter analgesic period compared to the pudendal block. A promising ultrasound-guided dorsal penile nerve block was recently described. We aimed to compare the analgesic effectiveness of ultrasound-guided penile nerve block with that of neurostimulator-guided pudendal nerve block.Thirty-three patients aged 1-7 years were included in this prospective, double-blinded, randomized controlled trial. Patients were divided into two

2019 Paediatric anaesthesia Controlled trial quality: predicted high

2. Dorsal Penile Nerve Block via Perineal Approach, an Alternative to a Caudal Block for Pediatric Circumcision: A Randomized Controlled Trial. Full Text available with Trip Pro

Dorsal Penile Nerve Block via Perineal Approach, an Alternative to a Caudal Block for Pediatric Circumcision: A Randomized Controlled Trial. General anesthesia combining with a caudal block (CB) has been commonly performed in pediatric patients undergoing circumcision surgeries. However, some severe complications have been suspected of a caudal block in the combined use. To avoid these issues of a caudal block, this study introduces a novel dorsal penile nerve block (DPNB) via perineum guided (...) by ultrasound as an alternative to a caudal block in pediatric circumcision surgeries.A total of 104 pediatric patients scheduled for circumcision surgeries were involved and randomly divided into 2 groups: the CB group (n=52) and the DPNB group (n=52). A laryngeal mask was inserted followed by induction and maintenance anesthesia of inhaled sevoflurane. In the DPNB group, a dorsal penile nerve block (DPNB) guided by a real-time ultrasonography was performed by a single injection via perineum of 0.25

2019 BioMed research international Controlled trial quality: uncertain

3. Dorsal penile nerve block for circumcision in pediatric patients: A prospective, observer-blinded, randomized controlled clinical trial for the comparison of ultrasound-guided vs landmark technique. (Abstract)

Dorsal penile nerve block for circumcision in pediatric patients: A prospective, observer-blinded, randomized controlled clinical trial for the comparison of ultrasound-guided vs landmark technique. Circumcision is a frequently performed procedure in day case pediatric surgery. Dorsal penile nerve block has proven its effectiveness for the management of acute postoperative pain after circumcision. We investigated if the ultrasound-guided placement of a dorsal penile nerve block could reduce (...) opioid requirement as compared to a landmark-based technique.Three hundred and ten prepubertal children, aged between 52 weeks postconception and 11 years, were included in this prospective, observer-blinded, randomized controlled trial and received either a landmark- or an ultrasound-guided dorsal penile nerve block, using a caudal needle and injecting 0.1 mL/kg levobupivacaine 0.5% bilaterally. A single, experienced investigator performed all blocks. The primary endpoint was the number of patients

2018 Paediatric anaesthesia Controlled trial quality: predicted high

4. Comparison of Intraoperative and Early Postoperative Outcomes of Caudal Versus Dorsal Penile Nerve Blocks for Outpatient Penile Surgeries. Full Text available with Trip Pro

Comparison of Intraoperative and Early Postoperative Outcomes of Caudal Versus Dorsal Penile Nerve Blocks for Outpatient Penile Surgeries. To compare intraoperative and 1-hour postoperative outcomes in caudal vs dorsal penile nerve block (DPNB) patients undergoing penile surgeries.We performed a retrospective cohort study of boys <10 years old undergoing penile procedures (2013-2015) using the Pediatric Regional Anesthesia Network, Pediatric Health Information System databases, and our medical (...) records. The primary outcome was a maximum Faces Limbs Activity Crying Consolability pain score of >3. Secondary outcomes were intraoperative-postanesthesia care unit (PACU) narcotics, preincision anesthesia time, adjusted operating room charges, and complications. We performed bivariate and multivariable analyses controlling for demographic and procedural characteristics and clustering by surgeon.Of 738 patients (mean age 2.1 years), 74.1% had a caudal block. DPNB patients were more likely to have

2017 Urology

5. Comparison of preventive analgesia techniques in circumcision cases: Dorsal penile nerve block, caudal block, or subcutaneous morphine? (Abstract)

Comparison of preventive analgesia techniques in circumcision cases: Dorsal penile nerve block, caudal block, or subcutaneous morphine? To compare 3 different techniques of preventive analgesia before circumcision operations in male children between 6-12 years of age. Our objective was to investigate the duration and quality of postoperative analgesia in patients, who were subject to caudal block technique, dorsal penile nerve block or who were administered subcutaneous morphine.The prospective (...) injections of 100 mcg/kg of subcutaneous morphine into the deltoid muscle. Patients in Group DP were subjected to dorsal penile nerve block with 1 mg/kg of bupivacaine 0.25%. Intraoperative haemodynamic data, pain and sedation scores, according to Children's Hospital of Eastern Ontorio Pain Scale and Ramsay Sedation Scale, were recorded at postoperative 1st, 6th and 24th hours in all cases.The 60 subjects in the study were divided into 3 groups of 20(33.3%) each. The overall mean age was 7.75±8.12 years

2017 JPMA. The Journal of the Pakistan Medical Association Controlled trial quality: uncertain

6. The safety and efficacy of dorsal penile nerve block for premature ejaculation: a systematic review and meta-analysis

The safety and efficacy of dorsal penile nerve block for premature ejaculation: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence

2019 PROSPERO

7. Pudendal Nerve Block Versus Penile Nerve Block in Children Undergoing Circumcision. (Abstract)

. The patients were randomly divided into two groups either receiving dorsal penile block group (PNB-Group) or pudendal nerve block (PDB-Group). In the PNB-Group, 0.3 ml/kg 0.25 % bupivacaine was used; and, in the PDB-Group, 0.3 ml/kg bupivacaine was applied with nerve stimulator at a concentration of 0.25%. In the postoperative period, the modified CHEOPS pain scale scoring and additional analgesic demand were evaluated at the 5th and 30th minutes and at the 1st and 2nd hours. The subsequent pain (...) Pudendal Nerve Block Versus Penile Nerve Block in Children Undergoing Circumcision. Penile nerve block is the most popular nerve block for the circumcision in pediatric patients. This study aimed to compare the analgesic efficiency of penile nerve block and the pudendal nerve block on postoperative pain and additional analgesic requirements in children undergoing circumcision.This prospective randomized double-blind study enrolled 85 children, aged 1 to10 years, undergoing circumcision

2018 Urology journal Controlled trial quality: uncertain

8. Dorsal Penile Nerve Block

Penile Nerve Block Aka: Dorsal Penile Nerve Block , Penile Anesthesia II. Technique: Dorsal Penile Nerve Block (infants) Indications Preparation Using a 1 cc tuberculin syringe, draw up 1 cc of 1% without Attach a 30 gauge 1" needle to syringe Procedure Patient lies supine Assistant holds legs to sides Apply antiseptic to injection site (hibiclens or betadine) Insert needle at dorsal base of penis at 10:00 position Insert superficially and raise a small skin wheel Advance needle, directed toward (...) : Dorsal Penile Nerve Block (adults) Indications Extensive penile procedure Preparation Draw all 3 agents into 30 cc syringe and then apply 27 gauge, 1.25" needle Typical infiltrate 10-15 cc of mixed solution (less than half of that prepared) Anesthetic mix Bupivicaine 1% without 10 cc 1% with 10 cc 10 cc Procedure Patient lies supine Mark injection entry site at mid-pubic arch at base of penis Apply antiseptic to injection site (hibiclens or betadine) Insert needle, aspirate and inject at both sides

2018 FP Notebook

9. Dorsal penile nerve block for rigid cystoscopy in men: study protocol for a randomized controlled trial. Full Text available with Trip Pro

that the dorsal nerve of the penis (DNP), the terminal branch of the pudendal nerve, innervates the membranous urethra in 53.3 % of specimens. In addition, the urethral mucosa has branches of innervated DNP. Dorsal penile nerve block (DPNB) is usually used for circumcision in children, and it has been shown to provide effective analgesia for penile surgeries. In this study, we hypothesized that DPNB could reduce the overall pain level in men during rigid cystoscopy.The trial is a prospective, randomized (...) Dorsal penile nerve block for rigid cystoscopy in men: study protocol for a randomized controlled trial. Pain is common in men undergoing rigid cystoscopy. Even with the application of a lubricant containing 2 % lidocaine, about 76 % of men suffer from mild to severe pain when undergoing rigid cystoscopy. The most painful part of the procedure for men is when the cystoscope passes through the membranous urethra. Song et al. (Neurourol Urodyn 29:592-5, 2010) did autopsies on males and found

2016 Trials Controlled trial quality: predicted high

10. Dorsal Penile Nerve Block With Ropivacaine-Reduced Postoperative Catheter-Related Bladder Discomfort in Male Patients After Emergence of General Anesthesia: A Prospective, Randomized, Controlled Study. Full Text available with Trip Pro

Dorsal Penile Nerve Block With Ropivacaine-Reduced Postoperative Catheter-Related Bladder Discomfort in Male Patients After Emergence of General Anesthesia: A Prospective, Randomized, Controlled Study. Catheter-related bladder discomfort (CRBD) is a distressing symptom complex after surgery, especially in male patients who have had urinary catheterization under general anesthesia. In this prospective, randomized, controlled trial, we compared dorsal penile nerve block (DPNB) with 0.33 (...) % ropivacaine with intravenous tramadol 1.5 mg kg(-1) in prevention of CRBD, as well as the incidences of postoperative side effects. Fifty-eight male patients aged 18 to 50 years, undergoing elective liver surgery and limb surgery with urinary catheterization, were enrolled and divided randomly into 2 groups. In the DPNB group, patients were given dorsal penile nerve block with 15 mL of 0.33% ropivacaine, and in the tramadol intravenous administration (TRAM) group, patients were given 1.5 mg kg(-1

2016 Medicine Controlled trial quality: predicted high

11. High Flow Priapism in a Pediatric Patient after Circumcision with Dorsal Penile Nerve Block Full Text available with Trip Pro

High Flow Priapism in a Pediatric Patient after Circumcision with Dorsal Penile Nerve Block We report the first documented case of high flow priapism after circumcision with dorsal penile nerve block. A 7-year-old male who had undergone circumcision three years before presented to our institution with a 3-year history of persistent nonpainful erections. Workup revealed a high flow priapism and, after discussion of the management options, the patient's family elected continued observation.

2016 Case reports in pediatrics

12. The analgesic effect of clonidine as an adjuvant in dorsal penile nerve block. Full Text available with Trip Pro

The analgesic effect of clonidine as an adjuvant in dorsal penile nerve block. Dorsal penile nerve block (DPNB) is a commonly performed regional anesthetic technique for male circumcision. The aim of this study was to assess the analgesic effect of the adjunction of clonidine to bupivacaine 0.5% in this block.It was a prospective randomized double-blind clinical trial including 40 ASA1 boys aged from 1 to 4 years undergoing elective circumcision. Dorsal penile nerve block was performed under (...) . Demographic parameters were similar in both groups. We noted no case of DNPB failure in this study. The supply for additional analgesia was seen in 12 patients in group 2 versus 3 cases in group 1. CHEOPS (Children's Hospital of Eastern Ontario Pain Scale) was significantly lower in group 1 from 2nd post operative hour until the 24th hour.Clonidine can be used in dorsal penile nerve block to improve and to prolong its analgesic effects after male circumcision.

2016 The Pan African medical journal Controlled trial quality: uncertain

13. Dorsal penile nerve block with ropivacaine versus intravenous tramadol for the prevention of catheter-related bladder discomfort: study protocol for a randomized controlled trial. Full Text available with Trip Pro

Dorsal penile nerve block with ropivacaine versus intravenous tramadol for the prevention of catheter-related bladder discomfort: study protocol for a randomized controlled trial. Catheter-related bladder discomfort (CRBD) is common in male patients under general anesthesia, and it may cause patient agitation and exacerbated postoperative pain. In this study, we will enroll male patients undergoing elective surgery with urinary catheterization after anesthetic induction and compare the efficacy (...) of a dorsal penile nerve block (DPNB) and intravenous tramadol for the prevention of CRBD.This trial is a prospective, open-label, randomized controlled trial that will test the superiority of a dorsal penile nerve block with 0.33% ropivacaine to the use of intravenous tramadol 1.5 mg/kg for CRBD prevention. A total of 60 male patients undergoing elective surgery with urinary catheterization after anesthetic induction will be randomized to receive either DPNB with 0.33% ropivacaine (DPNB group

2015 Trials Controlled trial quality: predicted high

14. Dorsal Penile Nerve Block for Rigid Cystoscopy in Men

when undergoing rigid cystoscopy, and approximately 27% men could still feel mild to moderate pain 7 days after the procedure. The most painful part of the procedure for men is when the cystoscope passes through the membranous urethra. Song et al did autopsy on males found dorsal nerve of the penis (DNP), the terminal branch of the pudendal nerve, innervates the membranous urethra in 53.3% specimens. In addition, urethral mucosa has branches of DNP innervated. Dorsal penile nerve block (DPNB (...) 22-G needle in the sub-pubic space at the base of the penis Drug: Ropivacaine 0.33% Ropivacaine administered around dorsal penile nerve using 22-G needle in the sub-pubic space at the base of the penis Experimental: Combination group Dorsal penile nerve block with ropivacaine and tetracaine gel into urethra before rigid cystoscopy Procedure: Dorsal Penile Nerve Block Dorsal penile nerve block with 0.33% ropivacaine using 22-G needle in the sub-pubic space at the base of the penis Drug

2015 Clinical Trials

15. Ultrasound-guided dorsal penile nerve block for ED paraphimosis reduction. (Abstract)

Ultrasound-guided dorsal penile nerve block for ED paraphimosis reduction. Adequate anesthesia for emergency department management of painful penile conditions such as paraphimosis or priapism is often both technically challenging and inconsistent using traditional landmark-based techniques of the dorsal penile block (DPB). The pudendal nerves branch to form the paired dorsal nerves of the penis providing sensory innervation to the skin of both the dorsal and ventral aspects of the penis (...) ) are sometimes required to achieve a clinically adequate block. In addition, inadvertent injection into the corpora cavernosa may occur. More recently, an ultrasound-guided approach has been developed. Using ultrasound, the dorsal penile nerves can be precisely targeted in the fascial compartment just deep to Buck fascia, potentially increasing block success rate and reducing the need for large local anesthetic volumes. Herein, we report the first adult case of an ultrasound-guided dorsal penile nerve block

2015 American Journal of Emergency Medicine

16. Ultrasound Guided Penile Block vs Pudendal Block for Hypospadias

Study Details Study Description Go to Brief Summary: Pain after hypospadias surgery is a challenging issue to solve for anesthesists. Many different analgesia techniques were defined in literature for this purpose. The investigators have implemented application of ultrasound guided dorsal penile nerve block into practice for these type of surgeries. Main purpose of this study is to compare the efficacy of nerve stimulator guided pudendal nerve block with ultrasound guided dorsal penile nerve block (...) Ultrasound guided dorsal penile nerve block will be administered after general anesthesia. 0,25% Bupivacaine 0,5ml/kg (max. 20ml) will be used for the blocks Procedure: Penile Block Ultrasound guided dorsal penile nerve block will be done to this group of patients preoperatively, under general anesthesia. 0,25% Bupivacaine 0,5ml/kg (max. 20ml) Drug: Bupivacaine (Block Drug) Block drug Active Comparator: Pudendal Block Nerve stimulator-guided pudendal block. 0,25% Bupivacaine 0,5ml/kg (max. 20ml

2018 Clinical Trials

17. Re: Dorsal penile nerve block prior to inflatable penile prosthesis placement: a randomized, placebo-controlled trial. (Abstract)

Re: Dorsal penile nerve block prior to inflatable penile prosthesis placement: a randomized, placebo-controlled trial. 23663611 2013 07 17 2013 05 13 1527-3792 189 6 2013 Jun The Journal of urology J. Urol. Re: Dorsal penile nerve block prior to inflatable penile prosthesis placement: a randomized, placebo-controlled trial. 2167-8 10.1016/j.juro.2013.02.113 S0022-5347(13)00389-3 Morey Allen F AF eng Comment Journal Article 2013 02 28 United States J Urol 0376374 0022-5347 J Sex Med. 2012 Nov;9

2013 The Journal of urology Controlled trial quality: predicted high

18. Dorsal penile nerve block for robot-assisted radical prostatectomy catheter related pain: a randomized, double-blind, placebo-controlled trial. Full Text available with Trip Pro

Dorsal penile nerve block for robot-assisted radical prostatectomy catheter related pain: a randomized, double-blind, placebo-controlled trial. Following Robotic-Assisted Radical Prostatectomy (RARP) patients routinely have penile pain and urethral discomfort secondary to an indwelling urethral catheter. Our objective was to assess the effect of dorsal penile nerve block with bupivacaine on urethral catheter-related pain after RARP.From 2012-2013, 140 patients with organ-confined prostate (...) cancer were enrolled in an IRB approved double-blinded, randomized control trial comparing a dorsal penile nerve block of bupivacaine versus placebo after RARP performed by a single-surgeon. Patients were asked to complete questionnaires using the Wong-Bakers FACES Pain Rating scale while hospitalized and for 9 days post-operatively, until the catheter was removed. The primary end-points were: catheter-related discomfort, abdominal (incisional) pain, and bladder spasm-related discomfort. Secondary

2014 SpringerPlus Controlled trial quality: predicted high

19. Levobupivacaine for postoperative pain management in circumcision: caudal blocks or dorsal penile nerve block. Full Text available with Trip Pro

Levobupivacaine for postoperative pain management in circumcision: caudal blocks or dorsal penile nerve block. In this study, we evaluated the analgesic efficacy and adverse effect profile of levobupivacaine in caudal and DPNB in postcircumcision pediatric patients.Sixty boys between 2-10 years of age undergoing circumcision were enrolled. The patients were divided into two groups: Group C (n=30) and Group P (n=30) were applied caudal block or dorsal penile nerve block (DPNB), respectively (...) the first 6 hours pain-free was larger in Group C than Group P (p=0.0001). The time to first analgesic (p=0.000033) and walking (p=0.004) were longer in Group C. There were 14 patients with motor block in Group C (p=0.00007). In view of AUC, FPRS, OPS and MPOPS were significantly better in Group C on the first postoperative 6 hours.Caudal block done using levobupivacaine for postoperative pain management in circumcision is more successful than penile block, however there is a significant delay in time

2013 Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology Controlled trial quality: uncertain

20. Nerve Block, Dorsal Penile

: May 21, 2018 Author: Gil Z Shlamovitz, MD, FACEP; Chief Editor: Meda Raghavendra (Raghu), MD Share Email Print Feedback Close Sections Sections Dorsal Penile Nerve Block Overview Overview Local anesthesia [ ] of the penis is used as preparation to perform various procedures, including , , , [ , , ] and repair of penile lacerations. The penis is innervated by the pudendal nerve (S2-S4). This nerve eventually divides into the right and left dorsal nerves of the penis that pass under the pubis (...) the list below: This technique can be used for anesthesia of complex penile skin lacerations or before attempting to manually reduce paraphimosis. Use a 27-ga needle to circumferentially infiltrate local anesthetic around the penis (see image below). Local infiltration – Circumferential penile block. Penile block See the list below: The right and left dorsal penile nerves should be blocked as proximally to the base of the penis as possible. Use a 27-ga needle to raise skin wheals at the 2- and 10

2014 eMedicine.com

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