Penile Ischemia as a Complication of Epinephrine Use in Penile Nerve Block: Truth or Myth?

• Main Authors: Palinrungi MA, Palinrungi ALR, Christeven R, Faruk M
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-08-01
• Series: Research and Reports in Urology
• Subjects: penile ischemia; skin necrosis; nerve block; circumcision; anesthetic agents
• Online Access: https://www.dovepress.com/penile-ischemia-as-a-complication-of-epinephrine-use-in-penile-nerve-b-peer-reviewed-fulltext-article-RRU

Muhammad Asykar Palinrungi,1 Andhini LR Palinrungi,2 Robert Christeven,3 Muhammad Faruk3 1Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia; 2Department of Surgery, Akademis Jaury Jusuf Putra Hospital, Makassar, South Sulawesi, Indonesia; 3Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, IndonesiaCorrespondence: Muhammad Asykar PalinrungiDivision of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Jalan Perintis Kemerdekaan KM 11, Makassar, South Sulawesi, 90245, IndonesiaTel [phone]Fax [phone]Email [e-mail]: The administration of a local anesthetic agent with epinephrine is controversial in penile surgery because of necrosis risk resulting from prolonged vasoconstriction of terminal vessels. We reported a case of an 8-year-old boy suffering from ischemia in the glans of the penis and epidermolysis of the penile skin after circumcision with penile nerve block using anesthetic agents containing epinephrine. The addition of epinephrine to the anesthetic agent (lidocaine) in penile nerve block before circumcision remains controversial. It remains controversial because multiple factors can cause skin necrosis after the circumcision. The adverse effect of epinephrine use in circumcision remains unproven because of a lack of scientific evidence. The administration of epinephrine in penile surgery is the decision of the physician.Keywords: penile ischemia, skin necrosis, nerve block, circumcision, anesthetic agents