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.