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Four Segments Versus two Segments Paravertebral Block for Inguinal Hernia Repair

Neelesh Bhatnagar, Assistant Professor, Department of Anesthesia, Geetanjali Medical College and Hospital, Udaipur, Rajasthan 313001, India. , Manmohan Jindal1 , Neelesh Bhatnagar2

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Indian Journal of Anesthesia and Analgesia 5(4):p 574-578, April 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5418.11

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Abstract

Background: Paravertebral block (PVB) has been successfully used to provide good analgesia with fewer side effects in inguinal herniorrhaphy. So, the present study was conducted to compare the characteristics of two segments with four segments PVB for anaesthesia and postoperative analgesia.

Material & Methods: Fifty patients of ASA grade I and II, aged between 1880 years scheduled for inguinal herniorrhaphy of a tertiary care teaching hospital were randomly selected in two groups of 25 each; Group F [Four segment block – T10, T 11, T 12, L1 (5ml 0.75% plain ropivacaine with 1:400000 epinephrine per segment)] and Group T [Two segment block – T10, and L1 (15ml 0.75% plain ropivacaine with 1:400000 epinephrine at T10 and 5 ml at L1)]. Onset, duration of surgical anaesthesia, duration of complete analgesia and effective analgesia were recorded. Postoperative pain was assessed at predetermined time intervals using visual analogue scale (VAS).

Results: The mean duration of application was 14.94±3.30 minutes in group F and 6.16±1.57 minutes in group T. (p<0.001) The mean duration of surgery start time in group F and group T was 27.40±2.55 minutes, 22.79±3.55 minutes respectively. (p<0.01) Group T showed 84% satisfaction level while group F showed 76%. VAS score in both the groups was found statistically insignificant at 0, 6, 12, 24, 36, 48Hrs interval.

Conclusion: Two segments technique of PVB can be a viable alternative to the four segments technique for inguinal hernia surgery because it is less time consuming, provides similar analgesia as compared to the four segment technique. Furthermore, decreasing the number of injections in the two segment block technique may further increase patient comfort and satisfaction.

 

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5418.11

Keywords

Paravertebral Block; Inguinal Herniorrhaphy; Analgesia; Visual Analogue Scale. 

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