(717) Predictors of Successful Penile Block Using Local Anesthetics for Adult Circumcision

Introduction Although circumcision typically allows for performing the procedure using penile block with local anaesthetics (LA), offering an effective analgesia while reducing the possible systemic side-effects of general anaesthesia (GA) and allowing for shorter recovery, very few studies investigated on this matter. We aimed to evaluate: a) the outcomes of LA circumcisions vs. those being performed under GA, and b) the possible predictors of a successful LA. Objective none Methods A retrospective analysis was conducted on 101 patients undergoing circumcision at our institution from 2020 to 2025. The primary endpoint was to define the predictors of a successful penile block using LA, defined as no-need for conversion to GA. We aimed also to define if the type of anaesthesia being adopted had any impact on the time to perform the procedure, being defined as the surgical time + the time to obtain an effective analgesia. Complications were evaluated based on the Clavien-Dindo classification. Descriptive statistics was used to describe the data. Mann-Whitney test was used to compare the median procedure-time in the LA- vs the GA- penile procedures. Univariate binomial logistic regression analyses were performed to define whether age predicted possible GA conversion. Results The median (interquartile range-IQR) age of the patients was 39 (21.5-66.5) years old. 87 and 14 patients underwent the circumcision under LA and GA, respectively. Overall, 23 procedures (26%) initially being performed under LA required conversion to GA. The median (IQR) procedure time was 38.5 (35-50) and 40 (38.5-48) minutes in the LA vs. GA group, respectively (p=0.5). At the univariate analysis, a younger age predicted an higher likelihood of GA conversion (OR 2.0, p=0.006). Overall, 10 patients had pain requiring the use of on-demand oral analgesics, 5 had circumcision-infection requiring antibiotics, and one required surgical revision due to penile haematoma. Conclusions These data seem to suggest that there may not be significant difference in terms of number of circumcisions being performed in an unit of time if the procedure is performed under LA vs. GA. Although LA seems safe and feasible for any patient undergoing a circumcision, and with a relatively-low probability of needing to convert to GA, some patient-related characteristics including a younger age should be considered in the counseling of these patients. Disclosure No