Missouri S | Volume 4; Issue 2 (2023) | Mapsci- JASR-3(2)-029 | Case Report Citation: Missouri S, Ray J, Geara E, Ayoub M, Grieco M. Administration of Spinal Anesthesia in the Jack-knife Prone Position for Anorectal Surgeries. J Anaesth Surg Res. 2023;3(2):178-83. DOI: https://doi.org/10.37191/Mapsci-JASR-3(2)-029 Journal of Anesthesia and Surgical Research Missouri S, et al.,2023-J Anaesth Surg Res Case Report Administration of Spinal Anesthesia in the Jack-knife Prone Position for Anorectal Surgeries Shairko Missouri * , Juliet Ray 2 , Elie Geara 1 , Mohamad Ayoub 1 and Michael Grieco 2 Abstract At the institution, anorectal surgeries are often done in prone- jackknife position, under Monitored Anesthesia Care (MAC) combined with either local infiltration or intrathecal spinal anesthesia. The traditional technique for spinal anesthesia is done with 0.75% hyperbaric Bupivacaine in a sitting position and the patient remains in this position for 10-15 minutes before turning into a prone jackknife position for the surgery. The other approach for spinal anesthesia is done while patient is already in a jackknife prone position and using 0.25% hypobaric Tetracaine, former technique is easier than the latter however demands a longer knife-to-skin time and patients are potentially prone for more hemodynamic instability. In this case series, three male adults who underwent anorectal surgery in the jackknife position with jack- knife position for spinal anesthesia and mild MAC has been described. The operating time was more efficient, the perioperative course and recovery were uneventful. Patient and staff satisfactions were encouraging and promising for the jackknife spinal anesthesia technique. A short acting hyperbaric local anesthetic will further enhance efficiency by shortening recovery and discharge time. Keywords: Spinal anesthesia; Hemi-spinal; Hypobaric; Anorectal surgery; Jackknife; Sensory; Motor. Introduction Minor anorectal diseases are rather common. The prevalence of the anorectal dis-ease is 4- 5% in adult population in the United States and 10% of those cases require an operation [1]. Due to its extensive nerve supply, anorectal surgeries are notorious for being extremely stimulating and painful therefore when it is performed under mild to moderate sedation, will often cause unwarranted adverse events like, pain, reflex body 1 MD, NYU School of Medicine Department of Anesthesiology, NY 10010, USA 2 MD, NYU School of Medicine Department of Surgery, NY 10010, USA * Corresponding Author: Shairko Missouri, MD, NYU School of Medicine Department of Anesthesiology, NY 10010, USA. Received Date: 10-23-2023 Accepted Date: 11-17-2023 Published Date: 11-28-2023 Copyright © 2023 by Missouri S, et al. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and