A Comparison of Spinal and Epidural Anesthesia in Pilonidal Sinus Surgery: A Prospective Randomized Single-Center Clinical Study
Objectives: Regional anesthesia techniques may be preferred to general anesthesia for pilonidal sinus surgery due to difficulties related to the prone position under general anesthesia. The aim of this study was to compare spinal anesthesia (SA) and epidural anesthesia (EA) with respect to perioperative and postoperative side effects and postoperative pain.
Methods: A total of 100 American Society of Anesthesiologist class I or II patients underwent pilonidal sinus surgery. The patients were randomly divided into 2 groups of SA (n=50) or EA (n=50). The perioperative and postoperative side effects related to anesthesia and postoperative pain level were compared between the groups.
Results: There was a significant difference with respect to the maximal sensorial height of block (EA: L1-L3; SA: T7-T11; p<0.001). The duration of the sensorial block was significantly longer in the EA group (290±23 minutes) compared with the SA group (215±6 minutes). No patient in the EA group developed motor block. There was no significant difference between the groups in the side effects related to anesthesia. The postoperative pain level was evaluated with the Visual Analogue Scale in the postoperative recovery room and at 6, 12, and 24 hours after surgery. None of the patients in either group required analgesic treatment for first 6 hours after the surgery. There was significantly less postoperative pain in the EA group compared with the SA group, except at the sixth hour, but the clinical difference was small.
Conclusion: EA may be preferred to SA due to better postoperative pain control and the absence of a motor block.
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