Spinal Anaesthesia Versus Inguinal Field Block In Assessing Intraoperative Effectiveness And Post Operative Pain Using Visual Analogue Scale For Inguinal Hernia Repairat Dr Prabhakar Kore Hospital & MRC, Belagavi

Abstract

Introduction: Inguinal hernial repair are commonly corrected by surgical treatment. The anesthetic methods in performing surgical inguinal repair include general, spinal or local anesthesia. However, these methods have recorded certain percentage of adverse effects and patient dissatisfaction especially with general anesthesia. Field blocks have also shown to be effective in promoting good anesthetic results along with less post -operative complication. However, till date spinal anesthesia and General anesthesia in IHR have been studied extensively, but the efficiency of inguinal field block is least studied. Hence our study aimed to evaluate the effectiveness of inguinal field block versus spinal anesthesia. Material and methods: A hospital based comparative study included a total of 60 subjects with unilateral inguinal hernia repair. Two groups with equal distribution of subjects were selected for spinal and inguinal field block. Outcome variable studied was the visual analogue pain scores measured on an ordinal scale with 6 categories. The inguinal field block was achieved by local anesthetic of 40ml mixture of equal volumes of 2 % of Lignocaine with adrenaline and 0.5% Bupivacaine and respective anatomical position with 20gauge short bevel needle inserted at a point 1 cm medial and inferior to ASIS. Pain scores, intra operative effectiveness etc., were considered as primary outcome variables. Clinical presentation was considered as Secondary outcome variable. P value < 0.05 was considered statistically significant. IBM SPSS version 22 was used for statistical analysis. Results: Total study subjects included in the study was 60. The two groups SA (spinal anesthesia) and the IFB (inguinal field block) group had 30 subjects each. The mean age of the subjects in the SA group was 46.93 ± 17.3 years and in the IFB was 39.27 ± 15.66 years. The post-operative pain scores for two groups at 6hrs and 12 hrs for SA was 3 and IF (inguinal field) group was 2. Pain scores at 18 and 24 hrs the for SA group was 2 and IF group1 respectively. The pain scores at all time intervals showed statistical significance with p<0.001. Conclusion: The post -operative pain in IFB was significantly less compared to SA. Hence field block can be effective in pain management among IHR.