Potential Errors

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  • Although the site of the puncture is correct, the needle is not maintained at the correct angle and plane, and consequently, the needle tip is closer to the 1:00 o'clock or 3:00 o'clock on the left (similarly for the infant's right side). The analgesia will obviously be suboptimal.

  • You must visualize where you are directing the needle tip and maintain the correct 25 to 45 degree angle and plane throughout the injection. You insert the needle too deeply, puncturing the deep fascia, and now the needle is in the corpus cavernosum, deep to the dorsal nerves. Injecting at this deep level will be like an intravenous injection of lidocaine, with potential side effects, and will not lead to effective analgesia. Pull back slightly to be in the deep subcutaneous fat level of the skin, just above the deep fascia of the penis (~ 1/2 the length of the 13mm needle).

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