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The paravertebral nerve root block for inguinal herniorrhaphy--a comparison with the field block approach
M R Wassef1, T Randazzo, W Ward
1Department of Anesthesiology, Elmhurst Hospital Center, Mount Sinai School of Medicine, New York, New York, USA.
Background And Objectives:
Our objective was to evaluate the efficacy of the paravertebral block for inguinal herniorrhaphy by comparison with the well-established field block.
Methods:
Thirty patients undergoing inguinal herniorrhaphy were randomly divided into two groups. Group A (n = 15) received paravertebral block of the ipsilateral nerve roots of T12, L1, and L2. Group B (n = 15) received field block. Each block was evaluated in terms of the degree of patient discomfort associated with surgical manipulations, requirement for supplemental anesthetic, the degree of patient discomfort associated with block performance, and the overall degree of patient satisfaction.
Results:
Both approaches were successful in blocking somatic sensory fibers. The paravertebral approach showed a significantly higher success rate than the field block (P < .01), regarding frequency of pain relative to surgical manipulation of the spermatic cord, hernial sac, and also in terms of need to supplement the surgery with local anesthetic (P < .01). The paravertebral block required significantly less local anesthetic and less needle insertions than the field block.
Conclusions:
The paravertebral nerve root block proved to be superior to the field block, to be devoid of side effects, and was acceptable to the patients.