Anesthesia Options for Your Pilonidal Surgery — What to Know
I Wanna Be Sedated! You’ve chosen your surgeon and surgery type. Now let’s help you understand how your care team keeps you comfortable and pain-free during the operation.
In the first version of this website, we called this page “I wanna be sedated”. To remain true to our origins, we suggest reading while humming the tune to yourself. We proudly accept the blame for the earworm.
The Goals of Anesthesia
- Amnesia (you won’t remember a thing)
- Analgesia (blockage of pain)
- Hypnosis (a state resembling sleep)
- Muscle Relaxation (oh, yeahhhhh)
- Anxiolysis (sedation)
- Antiemetic (reduces nausea)
Typical Anesthesia Types for Pilonidal Surgery
| Surgery Type | Most Common Anesthesia Type | Notes |
|---|---|---|
| Lancing / Incision & Drainage | Local only | Larger, more complex surgeries require greater control over patient immobility. |
| Pit Picking / Gips / Laser (SiLaC) | Local ± sedation (MAC) | Usually done in office/outpatient; sedation offered for comfort and to ease patient anxiety. |
| Excision with Open Healing | Spinal (saddle) block or Local ± sedation | Spinal preferred for pain control; local + sedation possible for shorter cases. |
| Excision with Closed Healing | Spinal block | Allows precise surgical work and patient immobility. |
| Bascom Cleft Lift | General anesthesia or tumescent local anesthesia | Larger, more complex surgery requires more control over patient immobility. |
| Karydakis Flap | General anesthesia | Larger, more complex surgeries require greater control over patient immobility. |
| Rhomboid (Limberg) Flap | General anesthesia (sometimes spinal) | Larger, more complex surgeries require greater control over patient immobility. |
Pilonidal Surgery Anesthesia FAQ
Do I get to choose my anesthesia?
In most cases, it is the anesthesiologist who makes the final decision about which type of anesthesia you should get. He/she is the sedation professional who takes you down the pathway to bliss and the one who monitors you all through surgery until you emerge on the other side. The surgeon is there to cut and sew, and the anesthesiologist is there to make the procedure as comfortable as possible for you. You can discuss anesthesia options with your surgeon during your consult if you have a strong preference.
Will I be asleep during the procedure?
It depends on the procedure type and how immobile your surgeon needs you to be. For some procedures, light sedation may be sufficient. For more extensive surgeries, you’ll need to go completely under to keep you as still as possible.
Will I feel any pain?
The job of your anesthesiologist is to keep you comfortable; you shouldn’t feel any pain, and you probably won’t remember any part of the procedure.
I feel anxious about being awake—can I add mild sedation?
When you meet with your anesthesiologist, you can request sedation. It’s fairly typical for the anesthesiologist to give you “a little something” to relax you before they move you into the OR. It’s possible that you may remember nothing after that kicks in. Most patients experience anxiety before surgery, and you can ask to have your anxiety reduced with some top-shelf drugs.
Additional Reading
Go Here Next:
Health care is a partnership; choose well when it comes to doctors and hospitals. How to build a great team.
Getting ready for the big day, how to prep for your surgery, what to expect when you arrive at the surgery center, and what to wear.
Going home from surgery and managing your first days at home post-surgery, especially when going to the bathroom.