Comparison of Spinal Anesthesia and Paravertebral Block in Inguinal Hernia Repair

Inguinal hernia repair (IHR) is a common surgical procedure which can be performed under general, regional, or peripheral nerve block anesthesia.

The aim of our study was to compare the efficacy of paravertebral block (PVB) with spinal anesthesia (SA) for IHR with respect to postoperative analgesia, ambulation, and adverse effects.

This was a prospective, single-blind randomized controlled trial.

Sixty American Society of Anesthesiologists Class I-II patients of 20-60 years scheduled for IHR were randomized by a computer-generated list into two groups of thirty each, to receive either PVB (Group PVB: at T12-L2 levels, 10 ml of 0.5% levobupivacaine at each level) or SA (Group SA: at L3-L4/L2-L3 level, 2.5 ml of 0.5% levobupivacaine). Primary outcome was duration of postoperative analgesia and time to reach discharge criteria. Secondary outcome was time to ambulation, time to perform the block, time to surgical anesthesia, total rescue analgesic consumption, adverse effects, hemodynamic changes, patient, and surgeon satisfaction.

Student's t-test, Chi-square test as applicable, and Statistical Package for Social Sciences (version 14.0, SPSS Inc., Chicago, IL, USA) were used.

Time to the first analgesic requirement was 15.17 ± 3.35 h in Group PVB and 4.67 ± 1.03 h in Group SA (P < 0.001). Time to reach the discharge criteria was significantly shorter in Group PVB than Group SA (P < 0.001).

PVB is advantageous in terms of prolonged postoperative analgesia and encourages early ambulation compared to SA.