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Dorsal penile nerve block complicated by local anaesthetic systemic toxicity

Year: 2024

Type: article

Abstract: A 39-year-old man presented with priapism. To facilitate corporal cavernosal aspiration, a dorsal penile nerve block was performed. A dose of 2000mg lignocaine was administered, instead of the intended 200mg. The patient developed local anaesthetic systemic toxicity, including hallucinations, loss of vision and agitation. This was treated with sedation, intubation, intravenous 20 % lipid emulsion, corporal aspiration and intensive care admission. The following day the patient was extubated and discharged. Clinical governance processes identified four potential causes for drug error. This is the third reported case of local anaesthetic systemic toxicity due to penile block in an adult. • To facilitate treatment for priapism in a man in his 30s, a penile block was performed. • A x10 intended lidocaine dose was given (2000mg), leading to hallucinations, loss of vision and agitation. • After sedation, intubation and intravenous lipid, the patient was discharged the next day. • Local anaesthetic systemic toxicity from urogenital instillation is rare but can be fatal.

Source: Urology Case Reports

DOI: 10.1016/j.eucr.2024.102911

Authors: Claris Oh, Ned Kinnear, Jason Lee

Institutions: Flinders Medical Centre, The University of Adelaide

Language: English

Topic: Anesthesia and Pain Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,060