Selective spinal anesthesia for inguinal herniorrhaphy

OBJECTIVE: To determine the characteristic profiles of 2 hypobaric spinal anesthetic solutions for selective spinal anesthesia in inguinal herniorrhaphy.

METHODS: The study took place in the general surgery room of Anesthesia Department, Ankara Numune Research and Training Hospital between May and July 2005 as a prospective, randomized and double-blind trial. Sixty-one ASA I-III patients scheduled for inguinal herniorrhaphy were randomly divided into 2 groups. Group R received combined spinal epidural anesthesia with ropivacaine 7.5 mg and group B received bupivacaine 5 mg; in both groups 25 ug of fentanyl was added. Solutions were diluted with 1.5 ml of sterile water. A Portex 18/27 or 16/27 needle was inserted at L1-2 or L2-3 with patients sitting upright; surgery began after the sensory block reached the T6 dermatome. Sensory and motor block characteristics, hemodynamic data, side effects, recovery time, the timing of the onset of pain, and the walkout were assessed.

RESULTS: Motor block duration was shorter in Group R (56.1 ± 36.1 minutes versus 72.5 ± 23.3 minutes) (p=0.013). Complete motor block duration was shorter in Group R. There was no difference between the 2 groups. Intra-group analysis showed that hemodynamic values after anesthesia induction were lower than initial values.

CONCLUSION: Ropivacaine plus fentanyl provided similar sensory anesthesia, but with a shorter duration of motor block than bupivacaine plus fentanyl when used for selective spinal anesthesia in herniorrhaphy surgery. Furthermore, we suggest that hemodynamic should be carefully monitored during surgery.