Local infiltration anesthesia versus spinal anesthesia in pilonidal sinus surgery

Abstract EN

Objective: To compare local infiltration anesthesia plus sedation with spinal anesthesia for pilonidal sinus surgery, with respect to recovery time, postoperative complications and patient satisfaction. Methods: This study was conducted at Prince Hashem Military Hospital, Zarqa.

A total of 64 patients were randomized into two groups; local infiltration anesthesia group (n=32) received local anesthesia of 20 ml 0.5% bupivacaine infiltrated around the pilonidal sinus plus 1.5-3 mg intravenous midazolam and spinal anesthesia group (n=32) received 1.5 ml of 0.5% bupivacaine into the subarachnoid space as spinal anesthesia.

Perioperative side effects, visual analogue pain scale score for three days, patient satisfaction and hospital stay were recorded and assessed. Results: Patients in the spinal anesthesia group spent more time in the operating theater and recovery room.

Two thirds of the patients in the local infiltration anesthesia group (65.6%) left the hospital on the day of surgery, compared to only (34.4%) in the spinal anesthesia group.

About 91% were satisfied in-group local infiltration anesthesia in comparison to 75% in the spinal anesthesia group.

Postoperative complications occurred in five patients of spinal anesthesia group ( 3 urinary retention and 2 spinal headache). Conclusion: Sacrococcygeal local infiltration anesthesia for pilonidal sinus resulted in lower complications, shorter hospital stay and more postoperative patient's satisfaction.