Comparison of bupivacaine (0.5%) and bupivacaine (0.5%) with dexmedetomidine (1 microgram/kg) in paravertebral block for inguinal hernia repair

Background: Paravertebral block(PVB),for inguinal hernia repair has been found to be effective than conventional spinal anaesthesia in terms of anaesthetic and analgesic technique , early ambulation and better postoperative pain score. Bupivacaine, an amide local anaesthetic, having a slow onset of action, provides early onset , prolonged duration of analgesia and adequate sedation in case of PVB with an adjuvant dexmedetomidine ,a highly selective alpha2 adrenergic agonist. Aims: To compare the efficacy as well as onset and duration of sensory and motor block ,duration of post operative analgesia ,any complication of the drugs bupivacaine and a combination of bupivacaine with dexmedetomidine in paravertebral block for inguinal hernia repair. Material and Method: 60 patients aged between 18-60 yrs of ASA physical status I and II , randomized in two groups of 30 to receive bupivacaine (0.5%) 1mgkg—1 in control group A and bupivacaine (0.5%) 1mgkg —1combined with dexmedetomidine (1 μgkg—1) in study group B for PVB. Results: Gr A vs Gr B was significant (P < 0.05) in sensory block ,8.2 ± 0.89 vs 4.95 ± 0.53 min in onset, 191.27 ± 7.12 vs 436.10 ± 16.33 min in duration , in motor block 12.20 ± 0.96 vs 7.66 ± 1.00 min in onset, 267.17 ± 9.67 vs 498.03 ± 22.94 min in duration. Duration of analgesia in Gr A vs Gr B was significant (P < 0.05) , 267.17±9.67 vs 498.03±22.94 min with no adverse effect. Conclusions: Bupivacaine dexmeditomine combination is superior to bupivacaine alone in onset, duration of sensory and motor block, postoperative analgesia in paravertebral block for inguinal hernia surgeries.