Adult Circumcision

Anesthesia Implications

Position: Supine, arms at side on armboards
Time: 30-60 min (short)
Blood Loss: Very Low (5-10 ml)
Post-op Pain: Minimal (1-3)
Maintenance Paralytic: No

Anesthetic Approaches

  • GLMA
  • GETT
  • MAC, Local Anesthetic
  • MAC, Spinal
The Anesthesia

Approach – LMA is usually the preferred approach, but GETT or Local/MAC can be used depending on the patient’s or surgeon’s preference. A spinal block can be indicated for patients with lung disease that would contraindicate general anesthesia.

Nerve Blocks – Two blocks may be administered: Dorsal penile and circumferential block. Both are typically done by the surgeon AFTER the patient is asleep. If asked to retrieve/draw up local anesthetic for the CIRCUMFERENTIAL block, DO NOT draw anything with epinephrine in it.

The Surgery

Circumcision is a common elective surgery for infant males 1-2 days after birth but can occasionally be performed on adults males for either cosmetic or functional purposes.

Types of functional penile issues that indicate an adult circumcision include: Phimosis, balanoposthitis, and paraphimosis. The surgeon will remove all or part of the foreskin, depending on the problem being addressed.