PARAVERTEBRAL BLOCK – A BETTER ALTERNATIVE TO SPINAL ANAESTHESIA FOR UNILATERAL INGUINAL HERNIA REPAIR

Dr B. Jeyarani; Dr S. Saiprabha

Volume : VII, Issue : VII, July - 2017

PARAVERTEBRAL BLOCK – A BETTER ALTERNATIVE TO SPINAL ANAESTHESIA FOR UNILATERAL INGUINAL HERNIA REPAIR

Dr B. Jeyarani, Dr S. Saiprabha

Abstract :

Background: Spinal anaesthesia is the most common technique performed for inguinal hernia repair. Since it has a quicker onset, easy to perform, provides adequate anaesthesia and muscle relaxation. But it also has some disadvantages like unpredictable level of block, post dural puncture headache, peripheral arterial vasodilation, adycardia and hypotension. Paraverteal block, being segmental in nature, can be expected to produce some advantages regarding haemodynamic stability and duration of analgesia.

Methods: Fifty male patients (ASA grade I and II) aged 18–65 years, posted for unilateral inguinal herniorraphy were enrolled into this randomized single blinded study. Patients were divided into two groups, to receive either paraverteal block (group‑P, n=25) at T10 to L2 or spinal anaesthesia (group‑S, n=25), respectively. Duration of analgesia and intraoperative hemodynamic stability were noted.

Results: Group P had prolonged duration of analgesia (p<0.0001) and better intraoperative haemodynamic stability when compared to group S. Group S had a fall in intraoperative MAP (86.7+5.67mmHg) from pre–operative MAP (90.2+3.7mmHg) which is statistically significant when compared with group P as there was not a fall in intraoperative MAP (90.4+4.07) from preoperative MAP (90.9+4.4mmHg).

Conclusion: Paraverteal block is superior to Spinal Anaesthesia in providing excellent surgical anaesthesia with very less hemodynamic disturbances and prolonged duration of analgesia. Moreover paraverteal block can be an attractive alternative in high risk patients as it provides better intraoperative hemodynamic stability and prolonged postoperative analgesia with minimal adverse events.