 A vasectomy is a 20-minute office-based procedure, and the American Neurologic Guidelines states that vasectomies should be performed under local anesthesia with or without oral sedation. It is a very rare situation where a vasectomy needs to be done under general anesthesia. After all, general anesthesia is expensive, and it comes with risk. If you're concerned of a vasectomy, call me, Dr. Lawrence Hatchett, the Vasectomy King.