Ventral Subcutaneous Injection Technique
Start at the ventral base of the penile shaft, just above the scrotum, by lifting up the penis vertically. Puncture the skin on the infant's left, lateral to the site of the eventual infiltration on the left. Tunnel the needle subcutaneously pass the midline raphé about 3mm and infiltrate 0.1ml (10 units) subcutaneously, forming a small wheal. See Figures 1 through 3 below.
Stop the infiltration, and withdraw the needle back to the corresponding lateral side of the raphé on the infant’s left. Infiltrate into a wheal the remaining 0.1ml. Then completely withdraw the needle from the more lateral puncture site.
This limits any loss of lidocaine solution from the second nearby infiltration. Because there are no major or important vessels in the ventral subcutaneous tissue, and the needle is so small, there is no need to first aspirate prior to the infiltration.
In this image: Figure 1. Correct position and technique of entry.
In this image: Figure 2. Incorrect entry point. Not lateral enough.
