Spinal anaesthesia versus general anaesthesia using laryngeal mask airway for anorectal surgeries in prone position: A controlled clinical trial

Abstract

Background Anorectal surgeries are of the commonest surgeries that are performed under different types of anaesthesia. The aim of this study was to compare the use of general anaesthesia (GA) using a laryngeal mask airway (LMA) with spinal anaesthesia (SA) in anorectal surgeries.Methods patients undergoing elective anorectal surgery were allocated into two anaesthesia modality groups. GA using LMA (group L) and SA using 7.5 mg of hyperbaric Bupivacaine (group S). Time spent on induction and recovery from anaesthesia was recorded for primary comparison. Secondary comparisons included postoperative analgesia requirements, occurrence of hemodynamic and respiratory adverse events, nausea, and vomiting. Patient and surgeon satisfaction were also recorded and compared.Results 64 patients were enrolled, 32 patients in each group. The time needed from induction of anaesthesia until patient is ready in prone position was comparable in the two groups. The time from the end of surgery until patient transfer from the operating theatre was significantly lower in the S group. Total analgesia required in PACU was significantly lower in the S group. There was no significant difference in hemodynamic complications or adverse events between the two groups. There was more surgeons’ preference of SA over GA, while there was no significant difference in the satisfaction of patients of both groups.Conclusion Both SA and GA using LMA are safe anaesthetic techniques for anorectal surgeries in the prone position. SA was associated with significantly lesser total time, less utilization of opioids analgesia in PACU, and higher satisfaction rates among surgeons.