Local infiltration anesthesia versus spinal anesthesia in pilonidal sinus surgery

ABSTRACT

To compare local infiltration anesthesia plus sedation with spinal anesthesia for pilonidal sinus surgery, with respect to recovery time, postoperative complications and patient satisfaction. 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. 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]. Sacrococcygeal local infiltration anesthesia for pilonidal sinus resulted in lower complications, shorter hospital stay and more postoperative patient's satisfaction