Continuous epidural blockade for treatment of drug-induced priapism.

摘要

Priapism is a persistent and painful penile erection that may be potentially organ threatening. Neuraxial blockade (ie, spinal and epidural anesthesia) with local anesthetics and/or opioids have been reported to induce priapism [1-3], particularly in patients undergoing urological procedures. However, there are reports describing the use of epidural anesthesia for the management of priapism in children with sickle cell anemia [4,5] and in an adult with renal failure who was taking antihypertensive medications [6]. It is unclear if epidural anesthesia would be beneficial in patients with priapism caused by the drugs used for the treatment of erectile dysfunction [7,8]. A patient with priapism associated with alprostadil, a drug used for erectile dysfunction, did not have a lasting response to multiple acute surgical interventions, while a subsequent, continuous epidural blockade with local anesthetics provided optimal treatment.