Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair
Background: Inguinal hernia repair can be performed under satisfactory anaesthetic conditions using general, regional and peripheral nerve block anaesthesia. Unilateral spinal anaesthesia provides optimal anaesthesia, with stable haemodynamics and minimal adverse events. The paravertebral block, bei...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wolters Kluwer Medknow Publications
2011-01-01
|
Series: | Indian Journal of Anaesthesia |
Subjects: | |
Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2011;volume=55;issue=6;spage=584;epage=589;aulast=Mandal |
id |
doaj-3cf892cf6d214cfdbc2450dc84878eb5 |
---|---|
record_format |
Article |
spelling |
doaj-3cf892cf6d214cfdbc2450dc84878eb52020-11-24T22:52:02ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50492011-01-0155658458910.4103/0019-5049.90613Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repairM C MandalS DasSunil GuptaT R GhoshS R BasuBackground: Inguinal hernia repair can be performed under satisfactory anaesthetic conditions using general, regional and peripheral nerve block anaesthesia. Unilateral spinal anaesthesia provides optimal anaesthesia, with stable haemodynamics and minimal adverse events. The paravertebral block, being segmental in nature, can be expected to produce some advantages regarding haemodynamic stability and early ambulation and may be a viable alternative. Methods: Fifty-four consenting male patients posted for inguinal hernia repair were randomized into two groups, to receive either the two-segment paravertebral block (group-P, n=26) at T10 and L1 or unilateral spinal anaesthesia (group-S, n=28), respectively. The time to ambulation (primary outcome), time to the first analgesic, total rescue analgesic consumption in the first 24-hour period and adverse events were noted. Results: Block performance time and time to reach surgical anaesthesia were significantly higher in the patients of group-P (P<0.001). Time to ambulation was significantly shorter in group-P compared to group-S (P<0.001), while postoperative sensory block was prolonged in patients of group-S; P<0.001. A significantly higher number of patients could bypass the recovery room in group-P compared to group-S, (45% versus 0%, respectively, P<0.001). No statistically significant difference in adverse outcomes was recorded. Conclusion: Both the paravertebral block and unilateral spinal anaesthesia are effective anaesthetic techniques for uncomplicated inguinal hernia repair. However, the paravertebral block can be an attractive alternative as it provides early ambulation and prolonged postoperative analgesia with minimal adverse events.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2011;volume=55;issue=6;spage=584;epage=589;aulast=MandalAnaesthetic techniqueearly ambulationinguinal hernia repairparavertebral blockpostoperative analgesiaunilateral spinal anaesthesia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
M C Mandal S Das Sunil Gupta T R Ghosh S R Basu |
spellingShingle |
M C Mandal S Das Sunil Gupta T R Ghosh S R Basu Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair Indian Journal of Anaesthesia Anaesthetic technique early ambulation inguinal hernia repair paravertebral block postoperative analgesia unilateral spinal anaesthesia |
author_facet |
M C Mandal S Das Sunil Gupta T R Ghosh S R Basu |
author_sort |
M C Mandal |
title |
Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair |
title_short |
Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair |
title_full |
Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair |
title_fullStr |
Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair |
title_full_unstemmed |
Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair |
title_sort |
paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair |
publisher |
Wolters Kluwer Medknow Publications |
series |
Indian Journal of Anaesthesia |
issn |
0019-5049 |
publishDate |
2011-01-01 |
description |
Background: Inguinal hernia repair can be performed under satisfactory anaesthetic conditions using general, regional and peripheral nerve block anaesthesia. Unilateral spinal anaesthesia provides optimal anaesthesia, with stable haemodynamics and minimal adverse events. The paravertebral block, being segmental in nature, can be expected to produce some advantages regarding haemodynamic stability and early ambulation and may be a viable alternative. Methods: Fifty-four consenting male patients posted for inguinal hernia repair were randomized into two groups, to receive either the two-segment paravertebral block (group-P, n=26) at T10 and L1 or unilateral spinal anaesthesia (group-S, n=28), respectively. The time to ambulation (primary outcome), time to the first analgesic, total rescue analgesic consumption in the first 24-hour period and adverse events were noted. Results: Block performance time and time to reach surgical anaesthesia were significantly higher in the patients of group-P (P<0.001). Time to ambulation was significantly shorter in group-P compared to group-S (P<0.001), while postoperative sensory block was prolonged in patients of group-S; P<0.001. A significantly higher number of patients could bypass the recovery room in group-P compared to group-S, (45% versus 0%, respectively, P<0.001). No statistically significant difference in adverse outcomes was recorded. Conclusion: Both the paravertebral block and unilateral spinal anaesthesia are effective anaesthetic techniques for uncomplicated inguinal hernia repair. However, the paravertebral block can be an attractive alternative as it provides early ambulation and prolonged postoperative analgesia with minimal adverse events. |
topic |
Anaesthetic technique early ambulation inguinal hernia repair paravertebral block postoperative analgesia unilateral spinal anaesthesia |
url |
http://www.ijaweb.org/article.asp?issn=0019-5049;year=2011;volume=55;issue=6;spage=584;epage=589;aulast=Mandal |
work_keys_str_mv |
AT mcmandal paravertebralblockcanbeanalternativetounilateralspinalanaesthesiaforinguinalherniarepair AT sdas paravertebralblockcanbeanalternativetounilateralspinalanaesthesiaforinguinalherniarepair AT sunilgupta paravertebralblockcanbeanalternativetounilateralspinalanaesthesiaforinguinalherniarepair AT trghosh paravertebralblockcanbeanalternativetounilateralspinalanaesthesiaforinguinalherniarepair AT srbasu paravertebralblockcanbeanalternativetounilateralspinalanaesthesiaforinguinalherniarepair |
_version_ |
1725667542079373312 |