Anesthesia for Undescended Testicles

The father of a nine-year-old boy is seeking recommendations for anesthesia during a possible upcoming surgery for undescended testicles.

SAC approved answer

If the patient is older than five and sufficiently cooperative, I would begin by putting EMLA cream on the patients hands and then, 90 minutes later, put an IV in. This will allow for painless IV insertion. We use oral ketamine and midazolam as an alternative approach to obtaining IV access.

There are a number of surgeons who are doing undescended testicle surgery with a laparoscope. Others are done through an incision similar to that used for hernia repair. I would need to know the proposed route the surgeon will use to provide a comprehensive recommendation, as my approach would be dramatically different if this were a laparoscopic procedure rather than hernia incisions.

AZ/TK 7-13-10

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