Effect Of Ultrasound-guided Paravertebral Block On Anesthesia For Unilateral Open Inguinal Herniorrhaphy

Objective To observe the efficacy and safety of ultrasound-guided paravertebral block on anesthesia for unilateral open inguinal herniorrhaphy.Furthermore,evaluating the application and efficacy of postoperative analgesia by ultrasound-guided paravertebral block and subarachnoid anesthesia in unilateral open inguinal herniorrhaphy to provide a safe,effective,less side effects and rapid recovery of clinical anesthesia and analgesia for patients with unilateral open inguinal herniorrhaphy.Methods Ten patients,American Society of Anesthesiology physical staus ? or ? grade,aged 18~89yr,scheduled for unilateral open inguinal herniorrhaphy were included.Ultrasound guided unilateral paravertebral block was applied at the level of T12 and L1 with 20ml0.5% ropivacaine respectively.Heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP)before and 15 min,40min after anesthesia,at the end and 6h after the surgery were recorded.In addition,the efficacy,success rate of anesthesia and complications of ultrasound guided unilateral paravertebral block were also recorded.The advantages and disadvantages of ultrasoundguided paravertebral block on anesthesia for unilateral open inguinalherniorrhaphy was compared with subarachnoid anesthesia based on the results above.Fourty patients,ASA ?~?,aged 18~89yr scheduled for inguinal herniorrhaphy were equally and randomly assigned to ultrasound guided unilateral paravertebral group(Group U)or subarachnoid anesthesia group(Group S)using randomization table.Ultrasound guided unilateral paravertebral block was applied at the level of T12 and L1 with20 ml 0.5% ropivacaine respectively in the group U.Subarachnoid anesthesia was applied with 20-30 mg ropivacaine at the interval of L3-4in the group S.Patient controlled intravenous analgesia pumps were applied for all patients after surgery.Observe the range of pain disappeared or decline,the change of the loop and success rate of anesthesia.VAS score at 4h,6h,8h,12 h,24h,48 h after anesthesia were record.Flurbiprofen ester intravenous injection was applied on resting VAS score > 4 after surgery.The frequency and the first time of using PCA,flurbiprofen ester usage,the indwelling catheters,ambulation 6h after surgery,hospitalization days,adverse reaction,and the satisfactions of surgeons and patients after operation were recorded.Results Block plane(T11,L1)(four digits),the success rate of block was 90%.The blood pressure and heart rate before and after paravertebral nerve block were no significant differences(P > 0.05),no significant complications were recorded.The blood pressure and heart rate in Group S were significantly lower than that in Group U after anesthesia(P <0.05)and that before practice in Group S(P <0.05).The frequency of PCA and VAS scores at 4h,6h,8h and flurbiprofen ester usage in group U were significantly lower than that in Group S.The first time of using PCA was significantly earier in Group S(P <0.05).The indwelling catheters,6hours after ambulation and hospitalization days were significantly lower in Group U(P <0.05).In addition,the satisfaction of surgeons and patients were significantly higher in Group U than that in Group S.However,there were not any statistical differences in success rate of anesthesia(P >0.05).Conclusions Ultrasound guided paravertebral block with good anesthesia,satifactory analgesic effect after operation,stable haemodynamics during operation,fast recovery,higher satisfaction of patient and surgery physician for unilateral open inguinal herniorrhaphy can meet the anesthesia of unilateral open inguinal herniorrhaphy.