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https://hdl.handle.net/11499/5298
Title: | Local anesthesia and midazolam versus spinal anesthesia in ambulatory pilonidal surgery | Authors: | Sungurtekin, Hülya Sungurtekin, Uğur Erdem, Ergün |
Keywords: | Ambulatory anesthesia Hospital costs Pilonidal surgery adrenalin bupivacaine midazolam naproxen pethidine prilocaine adult anus surgery backache clinical article clinical trial conference paper controlled clinical trial controlled study female headache hospital cost hospitalization human intermethod comparison length of stay local anesthesia male nausea pain assessment patient satisfaction postoperative complication postoperative pain priority journal rectum surgery sedation side effect spinal anesthesia urine retention vomiting |
Publisher: | Elsevier Inc. | Abstract: | Study objective: To evaluate two anesthetic techniques, namely, local anesthesia with sedation, and spinal anesthesia, with respect to recovery times, postoperative side effects, pain scores, patient satisfaction, and hospital costs for ambulatory pilonidal disease surgery. Design: Prospective, randomized study. Setting: University Hospital of Pamukkale. Patients: 60 consenting patients scheduled for pilonidal disease operation with Limberg flap technique. Intervention: Patients were randomly allocated into two groups: Group 1 (n = 30) received spinal anesthesia with hyperbaric bupivacaine 1.5 mL 0.5%, and Group 2 (n = 30) received local infiltration with a 50-mL mixture containing 10 mL bupivacaine 0.5%, 10 mL prilocaine HCl 2%, and 30 mL isotonic solution with 1:200 000 epinephrine in combination with intravenous (IV) midazolam sedation. Measurements: Perioperative and postoperative side effects, patient satisfaction, preoperative visual analog scale (VAS) pain scores, and VAS scores from the fourth hour postoperatively until the seventh day were assessed. Anesthesia, operation, surgery, and total hospital time, and costs (drug, resources, and labor) were recorded. Main results: No difference was found between groups in the frequency of side effects. Urinary retention was diagnosed in two patients in the spinal anesthesia group. There was no statistical significant difference seen in satisfaction scores between groups. No statistical significance in VAS pain scores between groups was noted except for the fourth postoperative hour values. The average time spent in the operating room (OR) was greater in the spinal anesthesia group. All Group 2 patients achieved fast-tracking criteria in the OR and were able to bypass the postanesthesia care unit (PACU). Total hospital time and total cost were significantly higher in the spinal anesthesia group than local anesthesia-sedation group (p < 0.05). Conclusion: The use of local anesthesia-sedation for ambulatory anorectal surgery resulted in a shorter hospital time, lower hospital costs, and no side effects compared with spinal anesthesia. © 2003 by Elsevier Science Inc. | URI: | https://hdl.handle.net/11499/5298 https://doi.org/10.1016/S0952-8180(03)00032-1 |
ISSN: | 0952-8180 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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