Ultrasonography-guided penile block for adult penile surgery

Gürkan, Yavuz; Kuş, Alparslan; Aksu, Can; Çiftçi, Seyfettin; Çulha, Melih; Pandin, Pierre

doi:10.1007/s12630-016-0596-z

Cited by 5 publications

(8 citation statements)

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“…Penile block is used in selected penile surgeries in both children and adults. [21][22][23][24][25] It is recommended to be administered with USG guide. 21,23,32 The advantages of using USG are to visualise the scarpa fascia, to enable the distribution of local anaesthetic, and to help prevent intravascular injection.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been used in the treatment of premature ejaculation. [24][25][26] According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle 8 deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing the sensation to the penis and clitoris in males and females including the urethra and bladder triangle. 8,27,28 Song et al performed autopsies on male cadaver and found that the dorsal nerve of the penis (DNP), the terminal branch of the pudendal nerve, innervates the membranous urethra in 53.3% of specimens.…”

Section: Introductionmentioning

confidence: 99%

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A randomised‐controlled, prospective study on the effect of dorsal penile nerve block after TURP on catheter‐related bladder discomfort and pain

Göğer

Özkent²,

Göger

et al. 2021

Int. J. Clin. Pract.

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In the present study, the impact of penile nerve block (PNB) on postoperative pain and Catheter-Related Bladder Discomfort (CRBD) in the transurethral resection of prostate(TURP) patients were evaluated. Methods:Participants of the present study were selected from patients who performed TURP under spinal anaesthesia for benign prostatic hyperplasia (BPH) between January 2018 and July 2020. The present study was planned as a single-centre, randomised-controlled prospective study in which the patients were divided into two groups. Group 1 was administered Control (n:40), and Group 2 ultrasonography(USG) guided PNB (n:40). The patients were included in the Groups, respectively. Visual analogue scale (VAS) scores were questioned and recorded in order to evaluate the postoperative pain complaints of the patients after the operation. In addition, in order to evaluate the CRBD, VAS scores were questioned and recorded as 0th, 0-1th hour, 1st-2nd hour, 2nd-4th hour, 4th-8th hour, 8th-12th hour, and 12th-24th hour.In addition, postoperative pain and need for analgesic drug were recorded. Tramadol was given to patients with moderate to severe CRBD. The findings were compared between the Groups.Results: There was no statistical difference demographic and per-operative data between Group 1 and Group 2. The CRBD and pain-related VAS scores were significantly higher in Group 1 between the 0 and 8th hours. There was no difference between VAS scores in the postoperative 8-24th hours. In total 24 hours, Group 2's need for tramadol was significantly less than Group 1. On examining the factors affecting CRBD in the multivariate analysis, age, body mass index(BMI), prostate volume, operation time do not affect CRBD statistically, and only PNB reduces CRBD (P: .029). While less drug-related complications were observed in Group 2, no serious complications related to PNB were observed. Conclusion:Penile nerve block is an effective method for the decrease pain and CRBD after urological surgery. It will also reduce the need for analgesics, and provide painless patients in the postoperative period. How to cite this article: Göger YE, Özkent MS, Göger E, et al. A randomised-controlled, prospective study on the effect of dorsal penile nerve block after TURP on catheter-related bladder discomfort and pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A randomised‐controlled, prospective study on the effect of dorsal penile nerve block after TURP on catheter‐related bladder discomfort and pain

Göğer

Özkent²,

Göger

et al. 2021

Int. J. Clin. Pract.

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“…However, Sandeman et al described a USG DPB technique with bilateral injections that made the technique safer and prolonged its analgesic effect . Gürkan et al improved this technique in the form of DPB with a single injection, and Türkyılmaz et al recently reported its use for hypospadias surgery with a 24‐hour pain‐free postoperative period. Faraoni et al compared conventional DPB with USG DPB and reported an increased (570 minutes) painless period with USG DPB until administration of the first analgesic.…”

Section: Discussionmentioning

confidence: 99%

“…Dorsal penile block was applied with patients in the supine position as described by Gürkan et al Following antiseptic preparation of the block area, an ultrasound probe was placed vertically at the base of the penile shaft at the midline over the pubic symphysis. This permitted identification of the penile shaft, inferior ramus of pubic bone, corpus cavernosum, and Scarpa's fascia (Figure ).…”

Section: Methodsmentioning

confidence: 99%

“…Blocks were performed before the start of surgery once the airway had been secured. A MyLab 6 US machine (Esaote) equipped with a large bandwidth, a multi-frequency linear probe (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and a 22G, 50-mm, ultrasound-visible stimulating needle (B. Braun Stimuplex Ultra 360) were used for block applications.…”

Section: Materials S and Me Thodsmentioning

confidence: 99%

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Ultrasound‐guided dorsal penile nerve block vs neurostimulator‐guided pudendal nerve block in children undergoing hypospadias surgery: A prospective, randomized, double‐blinded trial

Aksu

Akay

Şen

et al. 2019

Pediatric Anesthesia

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Background and Aims 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. Method Thirty‐three patients aged 1‐7 years were included in this prospective, double‐blinded, randomized controlled trial. Patients were divided into two groups and received either ultrasound‐guided dorsal penile nerve block or neurostimulator‐guided pudendal nerve block. All blocks were performed by the same two anesthesiologists, and the same surgeons performed the surgical procedures. The Face, Legs, Activity, Cry, and Consolability (FLACC) scale was used for postoperative pain management. The primary outcome of the study was time to first analgesic requirement. Secondary outcomes were FLACC scores at different time points, and types and cumulative doses of analgesic drugs. Results Dorsal penile nerve block provided longer analgesia than pudendal nerve block (32.29 ± 5.47 hours and 21.13 ± 3.53 hours, respectively; differences in mean: 11.16, 95% CI: 7.873‐14.465) (P < .001). FLACC scores at the time of first analgesic requirement were significantly lower in dorsal penile nerve block group than pudendal nerve block group (median [IQR]: 2 [2‐2.5] and 3 [3‐5], respectively; differences in median: −1, 95% CI: −1.851 to −0.149) (P < .001). Conclusion Ultrasound‐guided dorsal penile nerve block provided a longer analgesic period and reduced opioid consumption compared to neurostimulator‐guided pudendal nerve block.

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