The effect of anesthetic techniques in pilonidal sinus surgery

Abstract EN

Objectives : To compare local anesthesia plus sedation with spinal anesthesia for ano-rectal (pilonidal sinus) surgery, with respect to recovery time, postoperative complications and patient satisfaction.

Setting : Prince Rashid Military Hospital.

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

Peri-operative side effects, visual analogue pain scale score for three days, patient satisfaction and hospital stay were recorded and assessed.

Results : patients in spinal anesthesia group spent more time in operating theatre and recovery room.

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

Ninety and point 6 percent were satisfied in LA group compared to 75 % in SA group.

Postoperative complications occurred in five patients of spinal anesthesia group (3 urinary retention and 2 spinal headache).

Conclusion : Sacrococcygeal local anesthesia for pilonidal sinus resulted in lower complications, shorter hospital stay and more post-operative patient’s satisfaction.