Blocking the penis

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

blue needle

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

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