Comparative study between saddle block and local anesthesia on excision of pilonidal sinus by using ligaSure
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Ain-Shams Journal of Anesthesiology
(2020) 12:43
ORIGINAL ARTICLE
Open Access
Comparative study between saddle block and local anesthesia on excision of pilonidal sinus by using ligaSure Ayman Esmail Hussien*
and Amira Ibrahim Fahim
Abstract Background: The excision of the pilonidal sinus starts at 1833. Local, spinal, or general anesthetic procedures for the disease are widely used. The excision of the pilonidal sinus by using ligaSure reduces blood loss, reduces procedure time, and reduces patient length of stay. Therefore, the purpose of this study is to compare between local anesthesia and saddle block on the excision of the pilonidal sinus by using ligaSure, with respect to recovery time, postoperative complications, and patient satisfaction. Results: Forty patients were analyzed; the mean time of anesthesia, operation time, and operating room time were showing highly significantly lower in group LA when compared to group SA (P value < 0.01). At the postoperative period, patients in group LA experienced less intense postoperative pain with prolonged time of the first request for analgesia than patients in other groups. Conclusion: Local anesthesia has more efficacy in early start of anesthesia, early discharge from the hospital with prolonged analgesia, strong hemostasis, more patient satisfaction, and more than saddle block .Therefore, local anesthesia is considered as an alternative to the saddle block on the excision of the pilonidal sinus by using ligaSure. Keywords: Local anesthetic, Saddle block, ligaSure, Pilonidal sinus
Background Rational and background
Pilonidal sinus disease is a painful condition that usually occurs in the intergluteal zone, which carries a high recurrence rate of 37% after surgery (Jones 1992). It was first described by Mayo in 1833 (Hull and Wu 2002). Since that time, the disease has puzzled the physicians about its etiology, whether congenital or acquired. More than 78,000 troops were treated from this disease during the Second World War, which resulted in less intensive surgical treatment intended to get soldiers out of the hospital and return them to active duty. Therefore, most operations are now conducted as an ambulance (Matter et al. 1995; Ding et al. 2005; Levy and Emery * Correspondence: [email protected] Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
2003; Sungurtekin et al. 2003; Armstrong and Barcia 1994). Local, spinal, or general anesthetic procedures for the disease are widely used (Sungurtekin et al. 2003). LigaSure delivers a unique combination of pressure and energy to create a consistent seal with each use. It provides a combination of pressure and energy to create vessel fusion (Ding et al. 2005). Permanently fused vessels include 7 mm in diameter and tissue bundles without dissection or isolation in which the average seal cycle is 2 to 4 s when used with the Force Triad TM energy platform. It reduces blood loss compared to sutures and clips, reduces procedure time compared to sutures, and re
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