A Complication of Circumcision and Dorsal Nerve Block of the Penis

Dorsal nerve block of the penis for penile surgery, as the sole agent l ,2 or with general anaesthesia H to prevent laryngospasm and to provide immediate postoperative analgesia, has become a widely used and accepted practice.This paper reports two cases of gangrene of the skin of the glans penis, occurring in different institutions with different anaesthetists and surgeons.In both children (Case 1 aged thirteen months and weighing 9.8 kg; Case 2 aged three years, 12 kg) general anaesthesia was induced with thiopentone and maintained with nitrous oxide, oxygen and halothane supplement.In each case bupivacaine (Marcain) 0.5070 without adrenaline was drawn from a new ampoule and injected using the technique recommended by Brown and Fisk, 1979.In Case 1 two injections either side of the dorsal vein of 0.5 ml and in Case 2 one injection in the midline of 1.5 ml was administered.In both, a 25-gauge needle and a two-millilitre syringe was used.