# Testosterone effect on anesthesia depth in micropenis hypospadias surgery: A prospective cohort study

## TL;DR

This study examines how testosterone treatment affects anesthesia depth during micropenis hypospadias surgery and offers guidance for patients undergoing similar surgeries.

## Contribution

The study provides new insights into the impact of testosterone on anesthesia monitoring in specific surgical contexts.

## Key findings

- Testosterone treatment led to statistical differences in BIS, HR, and PIP values during surgery.
- Anesthesia depth monitoring is recommended for patients receiving testosterone treatment before surgery.
- Findings suggest testosterone may influence intraoperative physiological parameters.

## Abstract

To investigate prospectively the effect of testosterone treatment applied to patients with micropenis for hypospadias surgery on the depth of general anesthesia during surgery.Another objective was to make recommendations for the awareness of patients who have testosterone treatment used for sex reassignment surgery under anesthesia in the early period.

The study was a prospective cohort study conducted by the Department of Anesthesiology, Intensive Care and Pain Management of Tekirdağ Namık Kemal University Hospital between September 2024 and December 2024 (four months). We recorded the effect of intramuscular testosterone treatment administered to patients with micropenis hypospadias two weeks prior to surgery on the depth of anesthesia (1.1-1.2 MAC), as well as intraoperative changes in bispectral index (BIS), heart rate (HR), and peak airway pressure (PIP) at 5, 15, 30, 45, and 60 minutes.

Statistical differences were found between Group-C (Control) (n=30) and Group-T (Testosterone) (n=11). Although the depth of anesthesia was found to be between normal values for general anesthesia (BIS 40-60) in both groups, statistical differences were found between BIS, HR, and PIP values. (p< 0.05).

For surgeries requiring testosterone treatment (such as micropenis, after gender reassignment) in the acute phase or chronic phase under general anesthesia, monitoring of anesthesia depth is recommended.

Clinical Trial Number: This trial was prospectively registered on September 13, 2024 in clinicaltrials.gov with trial number “NCT06606496”.