Comparison of spinal versus caudal epidural anesthesia in the management of patients undergoing ambulatory perianal surgery: Randomized, prospective study

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Bozkurt Ç., Ertürk E., Akdoğan A., Kesicioğlu T., Aydın İ.

Journal of Clinical Medicine of Kazakhstan, vol.18, no.5, pp.76-81, 2021 (Peer-Reviewed Journal)



Objective: To compare levobupivacaine based caudal epidural

anesthesia and spinal anesthesia in terms of Intraoperative hemodynamic

changes and postoperative pain and patients’ satisfaction in subjects

undergoing perianal surgery in outpatient setting.

Material and methods: All consecutive patients who were scheduled

for perianal surgery. The difference in intraoperative hemodynamic

changes, sensory and motor block level, postoperative pain and patients’

satisfaction was the primary outcome measure of this study.

Results: There were no significant differences between the groups

in terms of mean arterial pressure and heart rate recorded. Subjects

randomized to spinal anesthesia had a significant extensive motor and

sensory block compared to those randomized to caudal epidural anesthesia.

Visual analogue scale (VAS) scores for surgical pain at postoperative 12 hours

was significantly higher in subjects receiving spinal anesthesia compared

to those receiving caudal epidural anesthesia (p=0.012). Time to first

analgesic administration was significantly lower in subjects randomized to

spinal anesthesia compared to those receiving caudal epidural anesthesia


Conclusion: Spinal anesthesia is associated with more extensive

sensory and motor block compared to caudal epidural anesthesia in

patients undergoing perianal surgery. Both techniques lead to similar

hemodynamic changes. Postoperative pain control is more favorable with

caudal block than the spinal anesthesia.