Related Experiment Video
Updated: Mar 16, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Impact of spinal versus general anesthesia on postoperative pain and long term recurrence after surgery for pilonidal
Markus M Luedi1, Peter Kauf2, Theo Evers3
1Department of Anesthesiology and Pain Medicine, Bern University Hospital Inselspital, University of Bern, Switzerland.
Study Objective:
To assess the effect of the kind of anesthesia on postoperative pain and long term recurrence rate in pilonidal sinus disease.
Design:
Retrospective study.
Setting:
Surgical departments of German Armed Forces Hospitals in Hamburg, Bad Zwischenahn and Hamm.
Patients:
583 pilonidal sinus disease (PSD) surgery patients operated for pilonidal disease.
Intervention:
Interview of randomly selected patients, who had been followed up to 20years after PSD surgery.
Measurements:
Analysis of long term recurrence-free survival and postoperative pain scores among patients who received different anesthesia modalities.
Main Results:
Recurrence occurred in 21.97% of patients who received general anesthesia with intubation (ITN), in 23.32% of spinal anesthesia (SPA), and in 31.91% of local- or cryoanesthesia. Our data indicate that there was no significant difference in recurrence-free time between the types of anesthesia in any of the surgical procedures applied. Pain scores of patients who underwent primary midline closure (4.74±2.63, 95% CI [4.36, 5.12]) were significantly lower than pain scores of patients who underwent marsupialization (6.12±2.71, 95% CI [5.17, 7.07]) or primary open treatment (6.09±2.79, 95% CI [5.79, 6.39]) (P<.0001). Post-operative pain scores did not differ between patients who received ITN or SPA. Cryo- or local anesthesia resulted in significantly lower post-operative pain scores compared to ITN (P=.0089) or SPA (P=.0031).
Conclusion:
The use of SPA or general anesthesia did not affect the long term recurrence rate in PSD. Postoperative pain experienced either in-hospital or after discharge did not differ between patients receiving ITN or SPA. With other cryo- or local anesthesia, postoperative pain score was significantly reduced in any surgical procedure. However, due to the higher recurrence rate after cryo- or local anesthesia, only SPA and general anesthesia should be applied. The decision whether spinal or general anesthesia is applied in PSD surgery remains a purely anesthesiological decision based on standard considerations.
Related Concept Videos
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:24General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:22Stages of General Anesthesia