International Journal of Colorectal Disease

, Volume 28, Issue 6, pp 873–880 | Cite as

Randomised clinical trial of pilonidal sinus operations performed in the prone position under spinal anaesthesia with hyperbaric bupivacaine 0.5 % versus total intravenous anaesthesia

  • Marc D. Schmittner
  • Sven Dieterich
  • Volker Gebhardt
  • Christel Weiss
  • Marc A. Burmeister
  • Dieter G. Bussen
  • Tim Viergutz
Original Article

Abstract

Purpose

The aim of this randomised clinical trial was to determine whether spinal anaesthesia (SPA) is superior to total intravenous anaesthesia (TIVA) in patients undergoing pilonidal sinus (PS) operations in the prone position.

Methods

After approval of the local ethics committee, suitable patients aged 19–49 years were randomised to SPA (7.5 mg hyperbaric bupivacaine) or TIVA (Propofol and Fentanyl). Cumulative consumption of analgesics, postoperative recovery, complications and patient satisfaction were evaluated.

Results

A total of 50 patients were randomised within a 24-month period. Median monitoring time in the recovery room was 0 (0–11) min for SPA versus 40 (5–145) min for TIVA (p < 0.0001). Patients in the SPA group were able to drink (40.5 (0–327) min versus TIVA 171 (72–280) min, p < 0.0001) and eat (55 (0–333) min versus TIVA 220 (85–358), p < 0.0001) earlier. More patients with a TIVA needed analgesics in the recovery room (SPA n = 0 versus TIVA n = 6, p = 0.0023) and suffered more frequently from a sore throat (SPA n = 0 versus TIVA n = 11, p = 0.0001). Two patients with a TIVA suffered from nausea and vomiting. Patients of both groups were equally satisfied with the anaesthesia technique offered.

Conclusions

SPA with 7.5 mg hyperbaric bupivacaine is superior to TIVA in patients undergoing PS operations in the prone position in terms of analgesia consumption in the recovery room, recovery times and postoperative complications.

Keywords

Pilonidal sinus Spinal anaesthesia General anaesthesia Hyperbaric Prone position 

Notes

Conflict of interest

The spinal needles were provided free of charge courtesy of B. Braun, Melsungen, Germany. M. Schmittner received financial support (fee, hotel, travel-costs) for presenting parts of the study at the Congress of the German Society of Coloproctology, Munich, Germany (March 2011), the Congress of the European Society of Anaesthesiology (ESA), Amsterdam, The Netherlands (June 2011) and the Capital Congress of the German Society of Anaesthesiology (HAI), Berlin, Germany (September 2011). Marc-Alexander Burmeister is Senior Vice President/Regional Head Marketing and Sales Central Europe at B. Braun Melsungen AG, Germany.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Marc D. Schmittner
    • 1
  • Sven Dieterich
    • 1
  • Volker Gebhardt
    • 1
  • Christel Weiss
    • 2
  • Marc A. Burmeister
    • 3
  • Dieter G. Bussen
    • 4
  • Tim Viergutz
    • 1
  1. 1.Department of Anaesthesiology and Surgical Intensive Care MedicineUniversity Medical Centre MannheimMannheimGermany
  2. 2.Department of Medical StatisticsUniversity Medical Centre MannheimMannheimGermany
  3. 3.B. Braun, Melsungen, Germany and Department of AnaesthesiologyUniversity Medical Centre Hamburg-EppendorfHamburgGermany
  4. 4.Centre of ColoproctologyMannheimGermany

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