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Effect of operative local anesthesia on postoperative pain outcomes of inflatable penile prosthesis: prospective comparison of two medications

International Journal of Impotence Research volume 30, pages 93–96 (2018)Cite this article

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Abstract

Few studies have examined the roles of dorsal penile nerve block (DPNB) and penile ring block (PRB) in surgery of inflatable penile prosthesis (IPP) placement. We sought to compare the postoperative pain outcomes of two different medications used in DPNB plus PRB. We thus carried out a prospective study of patients with erectile dysfunction who underwent “de novo” IPP placement between January 2013 and June 2013. Patients were divided to one of three groups: 1-DPNB plus PRB with bupivacaine injection; 2-DPNB plus PRB with ropivacaine injection and, 3-Control group without DPNB or PRB injection. Postoperative pain score and pain medication usage were recorded 2 h postoperatively, and every 24 h, for a week. The Visual Analog Scale (VAS) was used as pain scale measurement. A total of 131 patients were included in this study: 40 to bupivacaine, 47 to ropivacaine, and the rest were controls. Two hours postoperatively, mean VAS was significantly different (p < 0.0001) between medicated patients and the control group, however, no significant differences were observed between medication groups. Mean VAS was not significantly different among the groups from post-surgical day 2 thru 7. In conclusion, DPNB plus PRB during IPP provided effective analgesia in the immediate post-operative recovery.

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References

  1. Sinha S, Palta S, Saroa RA. Comparison of ultrasound-guided trans versus abdominis plane block with bupivacaine and ropivacaine as adjuncts for postoperative analgesia in laparoscopic cholecystectomies. Indian. 2016;60:264–9.

    CAS  Google Scholar 

  2. Gupta SL, Bidkar PU, Adinarayanan S, Prakash MV, Aswini L. Postoperative analgesia after inguinal hernia repair—Comparison of ropivacaine with bupivacaine: a randomized controlled trial. Anesth Essays Res. 2016;10:71–6.

    Article  Google Scholar 

  3. Weksler N, Atias I, Klein M, Rosenztsveig V, Ovadia L, Gurman GM. Is penile block better than caudal epidural block for postcircumcision analgesia? J Anesth. 2005;19:36–9.

    Article  Google Scholar 

  4. Hsu GL, Hsieh CH, Chen HS, Ling PY, Wen HS, Liu LJ, Chen CW, Chua C. The advancement of pure local anesthesia for penile surgeries:canan outpatient basis be sustainable? J Androl. 2007;28:200–5.

    Article  Google Scholar 

  5. Stolik-Dollberg OC, Dollberg S. Bupivacaine versus lidocaine analgesia for neonatal circumcision. BMC Pediatr. 2005;5:12.

    Article  Google Scholar 

  6. Raynor MC, Smith A, Vyas SN, Selph JP, Carson CC 3rd. Dorsal penile nerve block prior to inflatable penile prosthesis placement: a randomized, placebo-controlled trial. J Sex Med. 2012;9:2975–9.

    Article  Google Scholar 

  7. Beilin Y, Halpern S. Focused review: ropivacaine versus bupivacaine for epidural labor analgesia. Anesth Analg. 2010;111:482–7.

    Article  CAS  Google Scholar 

  8. Skolnik A, Gan TJ. New formulations of bupivacaine for the treatment of postoperative pain: liposomal bupivacaine and SABER-Bupivacaine. Expert Opin Pharmacother. 2014;15:1535–42.

    Article  CAS  Google Scholar 

  9. Rosenblatt MA, Abel M, Fischer GW, Itzkovich CJ, Eisenkraft JB. Successful Use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest. Anesthesiology. 2006;105:217–8.

    Article  Google Scholar 

  10. Weinberg G, Ripper R, Feinstein DL, Hoffman W. Lipid emulsion infusion rescues dogs from bupivacaine-induced cardiac toxicity. Reg Anesth Pain Med. 2003;28:198–202.

    Article  CAS  Google Scholar 

  11. Weaver JM. Calculating the maximum recommended dose of local anesthetic. J Calif Dent Assoc. 2007;35:61–3.

    PubMed  Google Scholar 

  12. Wiesel HC. Local anesthetics-maximum recommended doses. Anaesthesiol Reanim. 1997;22:60–2.

    Google Scholar 

  13. Yang CC, Bradley WE. Innervation of the human glans penis. J Urol. 1999;161:97–102.

    Article  CAS  Google Scholar 

  14. Ghanem H, Fouad G. Penile prosthesis surgery under local penile block anaesthesia via the infrapubic space. Int J Androl. 2000;23:357–9.

    Article  CAS  Google Scholar 

  15. Naja ZA, Ziade FM, Al-Tannir MA, Abi Mansour RM, El-Rajab MA. Addition of clonidine and fentanyl: comparison between three different regional anesthetic techniques in circumcision. Paediatr Anaesth. 2005;15:964–70.

    Article  Google Scholar 

  16. Flores S, Herring AA. Ultrasound-guided dorsal penile nerve block for ED paraphimosis reduction. Am J Emerg Med. 2015;33:863. e3-5

    Article  Google Scholar 

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Author notes

  1. These authors contributed equally: Donghua Xie, Marilin Nicholson, Mohammed Azaiza

Authors and Affiliations

  1. Urological Research Network, Hialeah, FL, 33016, USA

    Donghua Xie, Marilin Nicholson, Mohammed Azaiza, Victor Gheiler, Isabel Lopez, Boris Klopukh, Fernando J. Bianco, Paul Perito & Edward Gheiler

  2. Nova Southeastern University, Fort Lauderdale, FL, 33314, USA

    Donghua Xie, Guy M. Nehrenz, Boris Klopukh, Fernando J. Bianco, Paul Perito & Edward Gheiler

  3. Perito Urology, Coral Gables Hospital, Coral Gables, FL, 33146, USA

    Paul Perito

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  1. Donghua Xie
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  4. Victor Gheiler
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  5. Isabel Lopez
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Contributions

Acquisition of Data: MN, EG. Analysis and Interpretation of Data: MN, DX, IL, MA, VG, FB, EG. Drafting the Article: DX, MA, MN, EG. Revising it for Intellectual Content: IL, BK, GN, EG. Final Approval of the Completed Article: EG.

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Correspondence to Edward Gheiler.

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The authors declare that they have no conflict of interest.

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Xie, D., Nicholson, M., Azaiza, M. et al. Effect of operative local anesthesia on postoperative pain outcomes of inflatable penile prosthesis: prospective comparison of two medications. Int J Impot Res 30, 93–96 (2018). https://doi.org/10.1038/s41443-018-0025-7

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