Effect of Testosterone on Depth of Anesthesia in Micropenis Hypospadias Surgery - Comparison with Bispectral Index: A Prospective Cohort Study

Purpose To investigate prospectively the effect of testosterone treatment applied to patients with micropenis for hypospadias surgery on the depth of general anesthesia during surgery. Also, to make recommendations for the awareness of patients who have testosterone treatment used for sex reassignment surgery under anesthesia in the early period. Methods Our study is a prospective cohort study and was conducted by the Department of Anesthesiology, Intensive Care and Pain Management of Tekirdağ Namık Kemal University Hospital. We recorded the effect of testosterone (IM) treatment applied to patients with micropenis hypospadias 2 weeks ago, the depth of anesthesia under 1.1–1.2 MAC peroperatively, the changes in bispectral index (BIS) and heart rate (HR), peak airway pressure (PIP) at 5, 15, 30, 45, and 60 minutes. Results Statistical differences were found between Group K (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) Conclusion 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”.