Unilateral paravertebral block: an alternative to conventional spinal anaesthesia for inguinal hernia repair

Bhattacharya, Pradipta; Mandal, Mohanchandra; Mukhopadhyay, Soma; Das, Sushmita; Pal, Partha; Basu, Sekhar Ranjan

doi:10.1111/j.1399-6576.2009.02128.x

Cited by 33 publications

(34 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Berta et al 13 reported that the median duration of the PVB was found to be 600 minutes and in 10 children (41.7%) no additional analgesia was needed during the first 12 postoperative hours in renal surgery. A prolonged analgesic effect associated with the PVB technique in adults and children were noted in the other studies [4][5][6]9,10,[13][14][15][16][17] . Akçaboy et al 18 reported that PVB obtained very long and effective analgesia compared with spinal block in adult patients.…”

Section: Discussionsupporting

confidence: 55%

Single Level Paravertebral versus Caudal Block in Paediatric Inguinal Surgery

Tug

Özcengiz

Güneş

2011

Anaesth Intensive Care

View full text Add to dashboard Cite

Paravertebral block (PVB) has been used for postoperative analgesia in children since 1992. There are no prospective randomised studies comparing the use of PVB versus caudal block (CB) for outpatient inguinal hernia repair surgery. The hypothesis of this study is that a single level, single injection PVB can provide a longer duration of analgesia and less requirement for supplemental analgesia than single shot CB for children undergoing inguinal surgery. Seventy children, aged three to seven, American Society of Anesthesiologists score I to II, having unilateral inguinal surgery were enrolled in the study. The patients were divided into two randomised groups. In group PVB, a single shot of 0.2 ml/kg levobupivacaine was administered via the lumbar paravertebral route and in group CB, patients were given 1 ml/kg levobupivacaine caudally. Sevoflurane concentration was evaluated after induction and recorded during incision, sac traction and closure. Face, legs, activity, cry and consolability (FLACC) scores, heart rate, blood pressure and SpO 2 were evaluated postoperatively. Only four (11.4 %) patients in the PVB group needed rescue analgesic drugs compared to 12 (34.3%) patients in the CB group (P=0.044). Patients were given tramadol as rescue analgesia in the first four postoperative hours. No other supplemental analgesic drug was given apart from tramadol. FLACC scores were the same in the both groups. Parental satisfaction was significantly higher in the PVB group compared to the CB group (74.3 vs 40%, P=0.01). This study has demonstrated that a single level single injection paravertebral block provides superior intraoperative and postoperative analgesia when compared to a caudal block for unilateral inguinal hernia repair.

show abstract

Section: Discussionsupporting

confidence: 55%

Single Level Paravertebral versus Caudal Block in Paediatric Inguinal Surgery

Tug

Özcengiz

Güneş

2011

Anaesth Intensive Care

View full text Add to dashboard Cite

show abstract

“…[913] In our previous study,[4] the block performance time and time to surgical anaesthesia was found to be significantly greater in PVB compared to conventional SA. In our present study, we tried to maintain a slight medial direction of the block needle, to avert the pleural puncture.…”

Section: Discussionmentioning

confidence: 99%

“…PVB has been found to be more advantageous than conventional spinal anaesthesia for inguinal hernia repair, in terms of early ambulation and better postoperative pain scores. [4] We designed this study as a modification of our previous study,[4] to evaluate whether two-segment PVB can sustain as a viable alternative to unilateral SA as well. This was judged by comparing the time to ambulation (primary outcome), duration of postoperative analgesia and incidence of adverse events.…”

Section: Introductionmentioning

confidence: 99%

Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair

et al. 2011

View full text Add to dashboard Cite

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.

show abstract

“…Existing evidence favours local infiltration anaesthesia (LIA) for outpatient inguinal herniorrhaphy in terms of efficacy and time to discharge, although an ideal anaesthesia method remains a topic of debate . Anaesthesiologists are encouraged to use spinal anaesthesia in outpatient settings; however, discharge delay is considered as the main drawback …”

mentioning

confidence: 99%

Addition of lidocaine to bupivacaine for spinal anaesthesia compared with bupivacaine spinal anaesthesia and local infiltration anaesthesia

Yazicioglu

Akkaya

Kulaçoğlu

2013

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

Unilateral paravertebral block: an alternative to conventional spinal anaesthesia for inguinal hernia repair

Abstract: It can be concluded that unilateral PVB is more efficacious than conventional SA in terms of prolonging post-operative analgesia and reducing morbidities in patients undergoing elective unilateral inguinal hernia repair.

Cited by 33 publications

References 25 publications

Single Level Paravertebral versus Caudal Block in Paediatric Inguinal Surgery

Single Level Paravertebral versus Caudal Block in Paediatric Inguinal Surgery

Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair

Addition of lidocaine to bupivacaine for spinal anaesthesia compared with bupivacaine spinal anaesthesia and local infiltration anaesthesia

Contact Info

Product

Resources

About