• Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Giuseppe Paladini, Astrid U Behr, Fabio Gobbi, Tullio Pozone, Giorgio Danelli, Mauro Di Marco, Roberto Vicentini, Stefano Necozione, and Franco Marinangeli.
• aDepartment of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L'Aquila, L'Aquila, Italy bDepartment of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy cDepartment of Anesthesia and Intensive Care Unit, University of Chieti-Pescara, Chieti, Italy dDepartment of Anesthesia and Intensive Care Unit, Hospital of Padua, University of Padua, Padua, Italy eAnesthesia and Intensive Care Unit, Città della Salute e della Scienza di Torino, Turin, Italy fDepartment of Anesthesia and Intensive Care Unit, Hospital of Cremona, Cremona, Italy gDepartment of General Surgery, San Salvatore Academic Hospital of L'Aquila, L'Aquila, Italy.
• Pain. 2016 May 1; 157 (5): 1105-13.

AbstractInguinal herniorrhaphy is a common surgical procedure. The aim of this investigation was to determine whether unilateral paravertebral block could provide better control of postoperative pain syndrome compared with unilateral subarachnoid block (SAB). A randomized controlled study was conducted using 50 patients with unilateral inguinal hernias. The patients were randomized to receive either paravertebral block (S group) or SAB (C group). Paravertebral block was performed by injecting a total of 20 mL of 0.5% levobupivacaine from T9 to T12 under ultrasound guidance, whereas SAB was performed by injecting 13 mg of 0.5% levobupivacaine at the L3 to L4 level. Data regarding anesthesia, hemodynamic changes, side effects, time spent in the postanesthesia care unit, the Karnofsky Performance Status, acute pain and neuropathic disturbances were recorded. Paravertebral block provided good anesthesia of the inguinal region without patient or surgeon discomfort, with better hemodynamic stability and safety and with a reduced time to discharge from the postanesthesia care unit compared with SAB. During the postsurgical and posthospital discharge follow-ups, rest and incident pain and neuropathic positive phenomena were better controlled in the S group than in the C group. The consumption of painkillers was higher in the C group than in the S group throughout the follow-up period. Paravertebral block can be considered a viable alternative to common anesthetic procedures performed for inguinal hernia repair surgery. Paravertebral block provided good management of acute postoperative pain and limited neuropathic postoperative disturbances.

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