부산대학교 도서관

Introduction Benign anorectal diseases (such as hemorrhoidal disease, anal fissures, anal fistulas, anal abscesses, and anal polyps) present a wide-scale problem in surgical practice. (1,2,3,4,5) In addition to different surgical [...]
Aim: Benign anorectal diseases are common surgical procedures in general surgery. Various anesthetic techniques are utilized during surgical procedures. In this study, postoperative headache, urinary retention, and back pain were evaluated in patients operated under spinal anesthesia. Method: The incidence of postoperative headache, urinary retention and back pain was evaluated in patients operated under spinal anesthesia for benign anorectal disease (hemorrhoidal disease, pilonidal cyst, anal abscess, anal polyps, anal fissure, and anal fistulas) between January 1, 2016 and January 1, 2017. Patients for whom data was not available or who were operated under general or local anesthesia were excluded from the study. Results: Of the 302 patients whose data could be reached, 242 (80.1%) were operated under spinal anesthesia, 56 (18.5%) were operated under local anesthesia, and 4 (1.3%) were operated under general anesthesia within the 1-year period evaluated. Patients operated under spinal anesthesia included 152 (62.8%) patients with pilonidal cyst, 29 (12%) with hemorrhoidal disease, 41 (16.9%) with anal fistulas, 13 (5.4%) with anal abscess, 5 (2.1%) with anal fissures, and 2 (0.8%) with anal polyps. Postoperative headache was seen in 6 (2.5%) of the patients operated under spinal anesthesia, 3 (50%) of whom required rehospitalization for headache. The patients were treated conservatively with fluid replacement, caffeine, and nonsteroidal anti-inflammatory therapy. Urinary retention was seen in 6 (2.5%) patients and treated with temporary urinary catheterization. Permanent urinary retention was not seen any of the patients. None (0%) of the patients had back pain. Conclusion: Spinal anesthesia has low complication rates and can be a preferred anesthetic technique for benign anorectal disease surgery. Keywords: Spinal anesthesia, benign anorectal diseases, headache, urinary retention, back pain Amac: Selim anorektal hastaliklar genel cerrahi pratiginde yaygin olarak yapilan ameliyatlardir. Cerrahi prosedurde islem icin farkli anestezi tipleri tercih edilebilmektedir. Spinal anestezi altinda opere edilen hastalarda postoperatif bas agrisi, idrar retansiyonu ve bel agrisi sikayetlerinin oranlari degerlendirildi. Yontem: 1 Ocak 2016 ila 1 Ocak 2017 tarihleri arasinda klinigimizde benign anorektal hastaliklar (hemoroidal hastalik, pilonidal sinus, anal apse, anal polip, anal fissur ve fistul) nedeniyle spinal anestezi altinda opere edilen hastalarda postoperatif bas agrisi, idrar retansiyonu ve bel agrisi sikayetlerinin oranlari degerlendirildi. Verilerine ulasilamayan, genel anestezi veya lokal anestezi altinda opere edilen hastalar calismadan cikarildi. Bulgular: Benign anorektal hastaliklar nedeniyle bir yil sure icerisinde 302 opere edilen hastanin 242'si spinal anestezi (%80,1), 56'si lokal anestezi (%18,5), 4'u genel anestezi (%1,3) altinda opere edildi. Spinal anestezi uygulananlarun 152'si (%62,8) pilonidal sinus, 29'u (%12) hemoroid, 41'i (%16,9) anal fistul, 5'i (%2,1) anal fissur, 2'si (%0,8) anal polip ve 13'u (%5,4) anal apseydi. Spinal anestezi uygulanan hastalarin 6'sinda (%2,5) bas agrisi izlenirken 3'u (%50) tekrar yatis gerektirdi. Tum hastalar konservatif (sivi replasmani, kafein, steroid yapida olmayan anestezikler) olarak tedavi edildi. Alti hastada (%2,5) idrar retansiyonu izlendi ve gecici idrar kateterizasyonu ile tedavi edildi. Kalici idrar retansiyonu izlenmedi. Hicbir hastada bel agrisi sikayeti izlenmedi (%0). Sonuc: Benign anorektal hastaliklarin cerrahisinde spinal anestezi dusuk komplikasyon oranlari ile uygulanabilen bir anestezi teknigidir. Anahtar Kelimeler: Spinal anestezi, selim anorektal hastaliklar, bas agrisi, idrar retansiyonu, bel agrisi