Abstract

Aim: Spinal anesthesia is usually the anesthetic method of choice in pilonidal sinus surgery, which is mostly performed as an outpatient operation. Spinal anesthesia is administered via injection of local anesthetic agents into subarachnoid space. Throughout history, spinal needles have undergone changes and have greatly reduced in thickness. In this study, we aimed to compare the effects of caudal or cranially oriented spinal needle tips on anesthesia in patients undergoing pilonidal sinus surgery.

Materials and Methods: This study was performed prospectively with 60 patients who underwent pilonidal sinus surgery with spinal anesthesia at Medeniyet University Göztepe Training and Research Hospital between 01.03.2013 - 30.11.2013. Patients were randomly divided into two groups based on the direction of the spinal needle tip. 25 G Quincke tipped spinal needles were oriented caudally in Group A (n=30) and cranially in Group B (n=30). Two groups were compared in terms of anesthesia duration, hemodynamic parameters, and postoperative data.

Results: No difference was found in comparison of the demographic data of the two groups. Intraoperative mean arterial pressure and heart rate were significantly lower in both groups compared to baseline values. The incidences of postoperative headache, time until mobilization (min) were significantly high and time until first micturition (min) was significantly low in Group B.

Discussion: The data obtained from our study showed that cranial or caudal orientation of the spinal needle tips may have varying intraoperative and postoperative effects. We believe that further randomized controlled studies with larger sample sizes should be conducted to clarify the subject.