Slow injection of local anaesthetic will decrease pain during dorsal penile nerve block

Acta Anaesthesiol Scand. 1998 Sep;42(8):926-8. doi: 10.1111/j.1399-6576.1998.tb05351.x.


Purpose: To evaluate whether a very slow injection of local anaesthetics during dorsal penile nerve block for circumcision causes less pain than a more rapid injection.

Methods: In a prospective, double-blind, randomized study, 75 patients aged 15 to 53 yr (mean +/- SD = 22 +/- 8.4 yr) were randomized into two groups. A solution of 2% lidocaine, 1, and 0.5% bupivacaine, 0.5 without epinephrine to a maximum dose of 10 ml was injected using either a very slow rate (injection time 100 to 150 s, Group A) or a faster rate (injection time 40 to 80 s, Group B). Patients were questioned regarding pain by a physician who was blinded to the mode of therapy. Pain was rated as 1) mild (negligible), 2) moderate (non-negligible, but easily endurable), 3) intense (but endurable) and 4) total refusal to continue.

Results: A significant pain score difference was found between Groups A and B (median = 1 vs. 2, P = 0.0006) as well as a significant correlation between pain score and the rate of infiltration (rs = -0.394, P < 0.0001).

Conclusions: Slow injection is an important factor in reducing pain during penile block.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use*
  • Double-Blind Method
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Nerve Block / adverse effects*
  • Pain / prevention & control*
  • Pain Measurement / drug effects
  • Penis / innervation*
  • Prospective Studies


  • Anesthetics, Local