Regional Analgesia Techniques in Inguinal Hernia Repair: Continuous Paravertebral Block versus Epidural Anesthesia
DOI:
https://doi.org/10.48047/mnmmnq57Keywords:
Regional Analgesia, Inguinal Hernia Repair, Continuous Paravertebral Block, Epidural AnesthesiaAbstract
Background:. Inguinal hernia repair is among the most common operations worldwide and increasingly performed in older, comorbid
patients. Regional techniques shape perioperative stability, analgesia, opioid use, and discharge readiness. Epidural anesthesia (EA) provides
reliable bilateral neuraxial blockade but carries sympathectomy-related hypotension, urinary retention, and motor weakness. Continuous
paravertebral block (cPVB) offers unilateral, segmental somato-sympathetic blockade tailored to the surgical side and may preserve
hemodynamics while maintaining analgesic quality.This review synthesizes anatomical and physiological foundations and appraises
randomized trials and meta-analyses comparing cPVB with EA for inguinal hernia repair. Outcomes include pain scores, opioid-sparing effects, block reliability, hemodynamics, adverse events, mobilization, patient-reported recovery, and suitability for ambulatory pathways. We also address technique refinements (ultrasound guidance, catheter strategies), limitations (dermatomal spread variability, unintended epidural spread), and considerations in elderly and high-risk patients.
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References
Skandalakis JE, Colborn GL, Androulakis JA. Surgical anatomy and technique of groin hernia repair. Surg Clin North Am. 2000;80(1):27-54.
Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003;362(9395):1561-1571.
Aasvang E, Kehlet H. Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth. 2005;95(1):69-76.
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