Circumcision

Preoperative Diagnosis

Phimosis – tight foreskin

Balanitis - inflammation of the glans penis

Family preference for circumcision

Preoperative Considerations

Position

Supine

Age

Neonate to children

Surgical Time

30 min

EBL

Minimal

Associated Conditions

Infection

Circumcision

Excision of the preputial skin to expose the glans. It can be done for religious, ethical, social, or medical reasons.

Consider the use of a caudal or penile block for pain control

Anesthetic Considerations

Renal abnormalities may be present as part of a congenital malformation complex

Patients <5-10 yrs old: sevoflurane, N₂O, O₂

Older patients may agree to IV induction

Monitor closely for adequate ventilation during the procedure and before extubation

Pain mgt: acetaminophen, penile block

Ketorolac will decrease bladder spasms but causes renal insufficiency, so monitor renal function