Ultrasound-Guided Caudal Block versus Spinal Anesthesia for Anesthesia of Anorectal Surgeries in Adults

Background: Spinal anaesthesia (SA), local infiltration, general anaesthesia (GA), or caudal epidural blocks (CEB) are frequently used for anorectal surgery. Every one of these methods has advantages and disadvantages of its own. In this study, the block's success rate, the length of anaesthesia, the management of perioperative pain, and the satisfaction of perioperative patients were compared between the anaesthetic efficacy of SA and ultrasonography (US) guided caudal block in patients undergoing anorectal surgery.Methods: 60 patients of both sexes, aged ≥21, with non-oncological anorectal disorders, American Society of Anaesthesiologists I or II physical status, and undergoing elective anorectal procedures participated in this prospective randomised trial. There were two equal groups of patients: Group II received SA, whereas Group I received US-guided CEB.Results: Group I had a longer anaesthetic technique time than group II (P<0.001). Group I experienced a considerably longer time to initially request rescue analgesia than group II (P<0.001). Both the total amount of pethidine consumed and the number of patients in need of it were considerably lower in group I than in group II (P <0.001). Visual analogue scale was significantly lower at 4h, 5h and 6h in group I than group II (P<0.05). Peri-operative patient satisfaction, and rate of success of the block were insignificantly different between both groups. In both groups, no patient experienced respiratory depression.Conclusions: The US -guided CEB patients exhibited superior hemodynamic stability, reduced analgesic consumption, and prolonged time to rescue analgesia, along with reducing pain scores compared to SA patients.