Patient Acceptance Towards Paramedian Approach of Spinal Anaesthesia Versus Midline Approach in Proctological (Anorectal) Surgeries: A Prospective Comparative Study

Background: The method of spinal anaesthesia is selected when dealing with most proctological operations. The midline mode is conventionally a good choice, whereas the paramedian mode is often used in patients whose anatomy is difficult to locate. The objectives are to compare patient acceptance, comfort, proximal characteristics, and postoperative outcomes between the paramedian and midline techniques of spinal anaesthesia in patients undergoing elective anorectal surgery. Material and Methods: Within an anorectal surgery case study, 80 patients were asked to receive spinal anaesthesia between January and December 2025, which compared the patient acceptance, comfort, characteristics of the procedure, and postoperative outcomes between paramedian and midline methods. Two groups of patients were used (Group M, n=40) (midline approach) and (Group P, n=40). Patient acceptance was measured using a structured questionnaire and a visual analogue scale (VAS) for pain during needle insertion. Secondary outcome measures included the number of attempts, ease of landmark identification, time to a successful block, complications, and general patient satisfaction with the treatment, which showed significant differences between the paramedian and midline groups (p