Spinal Anesthesia in the Prone Position: A Case Series

Background Spinal anesthesia (SA) is a safe and effective strategy for many procedures, providing several advantages over general anesthesia. SA is usually performed in a sitting or lateral position, followed by careful repositioning to achieve the final surgical position. This mobilization process may cause technical difficulties related to the patient, consume valuable time, and lead to an unpredictable spread of the local anesthetic agent. To overcome these challenges, some authors have successfully performed SA with the patient already in the prone position. Methods In this article, we present a case series of 81 patients who underwent pilonidal sinus surgery under SA in the prone position. Results The technique achieved a 100% overall success rate, with 86.4% success on the first attempt. Adequate anesthetic block was obtained in all cases, without hemodynamic instability or respiratory complications during the procedure, and no complications related to the technique or patient positioning were observed. Conclusions SA performed in the prone position appears to be a safe and effective approach for pilonidal sinus surgery, providing high success rates and a low incidence of complications.