Abstract:

OBJECTIVE: A variety of surgical and anesthetic techniques have been used in an attempt to decrease postoperative pain or to limit the duration of hospital stay in pilonidal sinus surgery. Caudal blockade is an old, simple, and economic anesthetic technique that has been used for many years for superfi cial operations. Our aim is to verify whether caudal epidural block could be applied in pilonidal sinus surgery. METHODS: Two hundreds three patients were admitted to this prospective randomized study. Patients were randomly assigned to receive either caudal anesthesia, spinal anesthesia or local anesthesia with sedation. Operation time, early complication rate, pain intensity, motor function, time to home-readiness, time to oral intake, and time to fi rst request of supplemental analgesics were evaluated. Th e patients were followed up to 2 days after surgery. RESULTS: There were no statistically signifi cant diff erences between groups in patient demographics, operation time, early complication rate, and discharge time. All pain scores performed during the fi rst 24 hours after operation were in favor of the caudal group, with a statistically signifi cant diff erence throughout the fi rst 6 hours after surgery. Similarly, the need for postoperative analgesia was found to be statistically higher in the spinal and local anesthesia with sedation groups than in the caudal group for the fi rst 6 hours after surgery. CONCLUSION: Caudal anesthesia in selected cases is an eff ective, safe, and useful alternative to spinal anesthesia in pilonidal sinus surgery.

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