Regional Anesthesia for Anorectal Surgeries: What is the Best Solution?

Özet

Objective: Different regional anesthesia techniques are used in anorectal surgeries. The ideal anesthetic method should provide adequate analgesia, patient comfort and safety, and enable early mobilization. The aim of this study was to compare the effects of caudal block and saddle block techniques on post-operative analgesic consumption, number of patients requiring analgesic agent, and initial analgesic requirement. Methods: The current study included 71 patients undergoing elective anorectal surgery. In the saddle block group, we inserted 25 G Quincke spinal needle by the ultrasonography guidance into the intrathecal space at L4-L5 level and administered 7.0 mg hyperbaric bupivacaine. In the caudal block group, we inserted 20 G caudal needle by ultrasound guidance into the epidural space at S4-S5 level and administered 25 ml bupivacaine at a concentration of 0.5%. Results: In group caudal, post-operative analgesic consumption and number of patients requiring analgesic agent were significantly lower than group saddle (p<0.05). In group saddle, first analgesic requirement time was significantly lower than group caudal (p<0.05). Conclusion: In this study, significantly better results were obtained in group caudal regarding post-operative analgesic consumption, number of patients requiring analgesic agent, and initial analgesic requirements time. We concluded that caudal block can be more efficient for anorectal surgery in clinical practice.