e.g. for circumcision
weight / 3 = mls of 0.75% levy-bupivicane
Sterile precautions. Counter-traction as necessary.
1. Ring block at base of shaft
27 1/2 gauge needle
start at dorsum, just lateral to dorsal vein either side, aiming laterally. watching for circumferential spread.
inject at approx 3 o’clock and 9 o’clock for remaining ventral half.
inject into ‘watershed’ areas as needed to complete the ring
2. Dorsal n. of penis
identify pubic symphysis
two entry points, just lateral to midline on each side, just below PS
advance needle perpendicularly until bone is hit
Inject – resistance will be felt
Continuous pressure trying to inject while withdrawing – there will be sudden LOR as LA spreads within the correct plane/under Buck’s fascia. 0.5-2ml per side.
– EdM @ LRI