Ghanem H, Fouad G
Department of Andrology, Cairo University, Cairo, Egypt.
Int J Androl. 2000 Dec;23(6):357-9. doi: 10.1046/j.1365-2605.2000.00251.x.
The aim of this study was to evaluate the effectiveness and patient tolerance to local penile block anaesthesia via the infrapubic space with penile prosthesis implantation. Local anaesthesia was administered using a 23-guage 1.5-inch needle. A 50-50 mixture of 0.5% bupivicaine (Marcaine) and 0.5% lidocaine (Xylocaine) without adrenaline was injected into the infrapubic space with additional subcutaneous penile ring infiltration at the level of the penile root. A total number of 159 patients underwent this technique, mean age 57 years (range 34-86). In 148 (93%) patients, no booster sedation was needed; eight (5%) patients needed a boost of the pre-operative sedative during crural dilatation; three (1.8%) patients required general anaesthesia owing to insufficiently effective local anaesthesia and unexpectedly difficult dilatation. It is concluded that local anaesthesia was effective and safe to produce a pain-free procedure in 93% of cases. However, as the need for booster sedation or general anaesthesia exists, the procedure should be performed under monitored anaesthetic care and pre-operative evaluation should be performed as for general anaesthesia.
本研究的目的是评估经耻骨下间隙行阴茎假体植入术时局部阴茎阻滞麻醉的有效性及患者耐受性。采用23号1.5英寸针头进行局部麻醉。将不含肾上腺素的0.5%布比卡因（耐乐品）和0.5%利多卡因（赛罗卡因）按1:1混合液注入耻骨下间隙，并在阴茎根部水平额外行阴茎皮下环浸润。共有159例患者接受了该技术，平均年龄57岁（范围34 - 86岁）。148例（93%）患者无需追加镇静剂；8例（5%）患者在扩张阴茎脚时需要追加术前镇静剂；3例（1.8%）患者因局部麻醉效果不佳及意外的困难扩张而需要全身麻醉。结论是局部麻醉在93%的病例中能有效且安全地实现无痛手术。然而，由于存在追加镇静剂或全身麻醉的需求，该手术应在麻醉监测下进行，并且应像全身麻醉一样进行术前评估。
