Abstract
Ultrasound-guided paravertebral nerve block can provide effective somatic analgesia, which is safe and suitable for surgical patients. In this study, paravertebral nerve block was applied into open unilateral inguinal hernia repair surgery to observe its safety and analgesic effect. A total of 83 patients scheduled for open unilateral inguinal hernia repair surgery were randomly divided into two groups according to computer-generated randomization sequence with different methods of anesthesia: 42 patients with subarachnoid block (group A) and 41 patients with paravertebral nerve block (group B). The two groups were applied with different appropriate anesthesia methods accordingly. The perioperative vital signs, visual analog scale scores, time and dosage of additional analgesics, time to get out of bed, and complications of the two groups were monitored and recorded. In group B, the vital signs were more stable during the operation, the postoperative analgesia time was longer, the time for additional analgesics after the operation was later, the dose was less, the time to get out of bed was earlier, and the perioperative complications were less (P < 0.05). Ultrasound-guided paravertebral nerve block could meet the anesthesia requirements for open unilateral inguinal hernia repair surgery and provide effective postoperative analgesia.
Clinical Trial Identifier: ChiCTR1800017575.
Similar content being viewed by others
Materials and/or Code Availability
Not applicable.
References
Miller HJ (2018) Inguinal hernia: mastering the anatomy. Surg Clin North Am 98(3):607–621. https://doi.org/10.1016/j.suc.2018.02.005
Bullen NL, Massey LH, Antoniou SA, Smart NJ, Fortelny RH (2019) Open versus laparoscopic mesh repair of primary unilateral uncomplicated inguinal hernia: a systematic review with meta-analysis and trial sequential analysis. Hernia 23(3):461–472. https://doi.org/10.1007/s10029-019-01989-7
Kulhari S, Bharti N, Bala I, Arora S, Singh G (2016) Efficacy of pectoral nerve block versus thoracic paravertebral block for postoperative analgesia after radical mastectomy: a randomized controlled trial. Br J Anaesth 117(3):382–386. https://doi.org/10.1093/bja/aew223
Towfigh S (2018) Inguinal hernia: four open approaches. Surg Clin North Am 98(3):623–636. https://doi.org/10.1016/j.suc.2018.02.004
Pawlak M, Tulloh B, de Beaux A (2020) Current trends in hernia surgery in NHS England. Ann R Coll Surg Engl 102(1):25–27. https://doi.org/10.1308/rcsann.2019.0118
Park SK, Bae J, Yoo S, Kim WH, Lim YJ, Bahk JH, Kim JT (2020) Ultrasound-assisted versus landmark-guided spinal anesthesia in patients with abnormal spinal anatomy: a randomized controlled trial. Anesth Analg 130(3):787–795. https://doi.org/10.1213/ANE.0000000000004600
Miskovic A, Lumb AB (2017) Postoperative pulmonary complications. Br J Anaesth 118(3):317–334. https://doi.org/10.1093/bja/aex002
Bayrak M, Altıntas Y (2018) Comparing laparoscopic cholecystectomy in patients with chronic obstructive pulmonary disease under spinal anesthesia and general anesthesia. BMC Surg 18(1):65. https://doi.org/10.1186/s12893-018-0396-1
Saraswat V (2015) Effects of anaesthesia techniques and drugs on pulmonary function. Indian J Anaesth 59(9):557–564. https://doi.org/10.4103/0019-5049.165850
Abdulhai S, Glenn IC, Ponsky TA (2017) Inguinal hernia. Clin Perinatol 44(4):865–877. https://doi.org/10.1016/j.clp.2017.08.005
Ardon AE, Lee J, Franco CD, Riutort KT, Greengrass RA (2020) Paravertebral block: anatomy and relevant safety issues. Korean J Anesthesiol 73(5):394–400. https://doi.org/10.4097/kja.20065
Pushpanathan E, Pawa A (2016) Paravertebral block and access to the paravertebral space. Anaesthesia 71(11):1372–1373. https://doi.org/10.1111/anae.13657
D’Ercole F, Arora H, Kumar PA (2018) Paravertebral block for thoracic surgery. J Cardiothorac Vasc Anesth 32(2):915–927. https://doi.org/10.1053/j.jvca.2017.10.003
Tripathy S, Mandal I, Rao PB, Panda A, Mishra T, Kar M (2019) Opioid-free anesthesia for breast cancer surgery: a comparison of ultrasound guided paravertebral and pectoral nerve blocks. A randomized controlled trial. J Anaesthesiol Clin Pharmacol 35(4):475–480. https://doi.org/10.4103/joacp.JOACP_364_18
Krediet AC, Moayeri N, van Geffen GJ, Bruhn J, Renes S, Bigeleisen PE, Groen GJ (2015) Different approaches to ultrasound-guided thoracic paravertebral block: an illustrated review. Anesthesiology 123(2):459–474. https://doi.org/10.1097/ALN.0000000000000747
Bojaxhi E, Lee J, Bowers S, Frank RD, Pak SH, Rosales A, Padron S, Greengrass RA (2018) Paravertebral blocks reduce the risk of postoperative urinary retention in inguinal hernia repair. Hernia 22(5):871–879. https://doi.org/10.1007/s10029-018-1792-2
Fusco P, Cofini V, Petrucci E, Scimia P, Paladini G, Behr AU, Gobbi F, Pozone T, Danelli G, Di Marco M, Vicentini R, Necozione S, Marinangeli F (2016) Unilateral paravertebral block compared with subarachnoid anesthesia for the management of postoperative pain syndrome after inguinal herniorrhaphy: a randomized controlled clinical trial. Pain 157(5):1105–1113. https://doi.org/10.1097/j.pain.0000000000000487
Author information
Authors and Affiliations
Contributions
Pengcheng Xie: literature search; experimental studies; manuscript preparation; manuscript editing; manuscript review.
Yinglie Xu: concept; data acquisition; data analysis.
Yiming Wu: definition of intellectual content; data acquisition.
Xiang Ao: statistical analysis; design.
Corresponding authors
Ethics declarations
Ethics Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of Fudan University Pudong Medical Center (No. LX2018-002).
Consent to Participate
Informed consent was obtained from all individual participants included in the study. Patients signed informed consent regarding publishing their data.
Consent for Publication
The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1, 2, 3, and 4. This manuscript is approved by all authors for publication. I hereby declare on behalf of my co-authors that the work described was original research that has not been published previously, and not under consideration for publication elsewhere, in whole or in part. All the authors listed have approved the manuscript that is enclosed.
Competing Interests
The authors declare no competing interests.
Data Sharing
No additional data available.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Pengcheng Xie and Yinglie Xu are both first authors.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Xie, P., Xu, Y., Wu, Y. et al. Randomised Controlled Clinical Trial of Spinal Anesthesia Versus Paravertrebral Block for Hernia Surgery. Indian J Surg (2023). https://doi.org/10.1007/s12262-023-03686-3
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s12262-023-03686-3