Dorsal penile nerve block complicated by local anaesthetic systemic toxicity

A 39-year-old man presented with priapism. To facilitate corporal cavernosal aspiration, a dorsal penile nerve block was performed. A dose of 2000mg lignocaine was administered, instead of the intended 200mg. The patient developed local anaesthetic systemic toxicity, including hallucinations, loss of vision and agitation. This was treated with sedation, intubation, intravenous 20 % lipid emulsion, corporal aspiration and intensive care admission. The following day the patient was extubated and discharged. Clinical governance processes identified four potential causes for drug error. This is the third reported case of local anaesthetic systemic toxicity due to penile block in an adult.