Division of Urology, The University of North Carolina School of Medicine, Chapel Hill, NC 27599-7235, USA.
J Sex Med. 2012 Nov;9(11):2975-9. doi: 10.1111/j.1743-6109.2012.02756.x. Epub 2012 May 29.
Dorsal penile nerve block (DPNB) has been previously shown to provide effective analgesia for penile surgeries. To date, few studies have examined the role of DPNB prior to inflatable penile prosthesis (IPP) implantation.
The purpose of this study was to assess the efficacy of local penile nerve block prior to IPP implantation for postoperative pain control.
The primary outcome was postoperative pain rated using the visual analog scale (VAS). Secondary outcome measures included total narcotic usage during hospitalization.
Institutional Review Board approval was obtained. Patients with erectile dysfunction scheduled for IPP implantation were approached for study participation. Patients were excluded if they had a previous IPP scheduled for revision or replacement or were undergoing additional procedures during the same operative session. Patients were then randomized to either DPNB with 1% lidocaine and 0.5% bupivacaine without epinephrine or injectable saline placebo. Only the resident surgeon assisting in the case was aware of randomization. All procedures were performed by a single surgeon (C.C.C.). Postoperatively, patients were asked to rate their pain using a VAS hourly while in recovery, at 4 hours, and at 23 hours postoperatively. Total narcotic usage was also measured.
A total of 30 patients underwent randomization with 15 patients in each group. Baseline demographic data were similar in each group. There was a significant reduction in pain in the immediate postoperative period and at 4 hours after surgery in the treatment group when compared with placebo (VAS 2.5 vs. 5.3, P = 0.009 at 0 hours; VAS 2.8 vs. 5.1, P = 0.011 at 4 hours). Narcotic usage was similar among both groups. There were no perioperative or early postoperative complications in either group.
DPNB is safe and effective for reducing pain in the early postoperative period following penile prosthesis implantation.
阴茎背神经阻滞（DPNB）已被证明可有效缓解阴茎手术的疼痛。迄今为止，很少有研究检查 DPNB 在可膨胀阴茎假体（IPP）植入术前的作用。
本研究旨在评估 IPP 植入术前阴茎神经阻滞对术后疼痛控制的效果。
主要观察指标为使用视觉模拟评分（VAS）评估术后疼痛。次要观察指标包括住院期间总麻醉药物用量。
获得机构审查委员会批准。向计划接受 IPP 植入术的勃起功能障碍患者介绍研究参与情况。如果患者之前有 IPP 计划进行修复或更换，或在同一手术期间进行其他手术，则将其排除在外。然后，患者被随机分为 1%利多卡因和 0.5%布比卡因加肾上腺素的 DPNB 组或不含肾上腺素的注射生理盐水安慰剂组。只有协助手术的住院医师知道随机分组情况。所有手术均由一位外科医生（C.C.C.）完成。术后，患者在恢复室中每小时使用 VAS 评估疼痛，在 4 小时和 23 小时后评估疼痛。还测量了总麻醉药物用量。
共有 30 名患者接受了随机分组，每组 15 名。两组患者的基线人口统计学数据相似。与安慰剂组相比，治疗组在术后即刻和术后 4 小时疼痛明显减轻（VAS 2.5 与 5.3，P=0.009，0 小时；VAS 2.8 与 5.1，P=0.011，4 小时）。两组患者的麻醉药物用量相似。两组均无围手术期或早期术后并发症。
DPNB 安全有效，可减少阴茎假体植入术后早期疼痛。
