This reflex is elicited by stroking the superior and medial part of the thigh in a downward direction. The normal response is a contraction of the cremaster muscle that pulls up the scrotum and testis on the side stroked.
In children, this reflex may be exaggerated, and this can lead to the mistaken diagnosis of undescended testes.
Upper and lower motor neuron disorders, as well as a spine injury of L1-L2, can cause an absence of the cremasteric reflex. It has also been reported to be absent in 100% of cases of testicular torsion, making it a useful sign in this difficult diagnosis.
This study was conducted in order to investigate the effects of bupivicaine or meperidine, used in spinal anaesthesia, on the cremastericreflex, and to determine whether the reflex is an indicator for sufficient spinal with bupivicaine or meperidine anaesthesia in adult male patients.
The reflex, which is present to a variable extent in newborns and during infancy (6), and is thus not useful in children (7,8), is clearly an easy and objective indicator for spinal anaesthesia with local anaesthetics in male adults (4).
In conclusion, we think that the cremaster reflex may be used as an indicator of sufficient spinal anaesthesia with meperidine for lower abdominal, perineal and lower limb surgery, in adult males.
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