Varaprasad Raghupatruni, Eswari Prasanna Pilla, Priyathama Sankar Kanneganti
BACKGROUND Paravertebral block was first given in 1905. A renaissance of this technique is now being extensively done for intraoperative and postoperative pain relief because it is effective, easy to perform and has few complications. Spinal analgesia is a routine procedure for infra-umbilical surgeries, but has the drawback of its cardiovascular effects. We compared the two techniques of PVB and SA for unilateral hernioplasty done for inguinal hernia to study the haemodynamic characteristics (heart rate and mean arterial pressure), onset and duration of sensory loss and VAS scores in the first 24 hours after surgery. MATERIALS AND METHODS This was a randomized, prospective, single blind study. Sixty male patients of American Society of Anesthesiologists physical status grade I – III of age 35 to 65 years with unilateral direct or indirect hernia were taken for study. They were randomly divided into two groups of thirty each. Group SA received spinal analgesia and Group PVB received lumbar paravertebral block. Mean Arterial Pressure, heart rate and SpO2 were recorded preoperatively and throughout the surgical procedure. Demographic profile, surgical data, patient satisfaction, onset time to reach T10 dermatome, peak sensory level and postoperative nausea and vomiting were recorded. The VAS scores at postoperative 0-24 hours were measured. RESULTS There was decrease in heart rate and mean arterial pressure in the first 15 minutes in the SA group which was statistically significant compared to the PVB group (p=0.01). The sensory block was longer in the PVB group and with lower VAS scores. CONCLUSION Paravertebral block provides good surgical analgesia without haemodynamic fluctuations and gives satisfactory postoperative pain relief.
