DORSAL PENILE NERVE BLOCK KID

DORSAL PENILE NERVE BLOCK 4yr 15kg kid posted for circumcision. Regional anaesthesia anatomy : Dorsal penile nerve (DPN) arises roughly at around 10 0" clock and 2 o" clock position at the base of the penis at he level of BUCK"S fascia.In our procedure we insert needle distal to base of penis and proceed subcutaneously towards base ! Advantage of Distal insertion of needle is easy control / pressing of bleeding at the insertion point if any ! DPN provides Sensory innervation to shaft of penis,foreskin and glans ! But Posterior scrotal branch of perineal nerves which runs paraurethrally to the VENTRAL surface of the penis and the FRAENUM ! To complete anaesthesia and analgesia one have to inject few ml of LA in the groove between corpus cavernosa and spongiosum at ventral surface of base of penis to catch this nerve! Child was induced with halothane in front of father and canulated ! Video was taken and showed to father and edited and published after written informed consent only. 0.25% Levobupivacine 5ml=12.5mg.Procedure completed with oxygen / nitrous and intermittent halothane through nasal prongs ! Analgesia lasted for 6hrs along with paracetamol and ibuprofen.Immediate oral resumes with discharge at 6hrs