Continuous Paravertebral Block Versus Epidural Anesthesia for Inguinal Hernia

Background: Regional anesthesia provides advantages over general anesthesia in open inguinal hernia repair. This study compared continuous EA and ultrasound-guided PVB as sole anesthetic techniques for open inguinal hernia repair. Methods: In this prospective, randomized, single-blinded trial, 30 patients scheduled for elective unilateral open inguinal hernia repair were randomized into two groups: EA (n = 15) and PVB (n = 15). Demographics, block characteristics, intraoperative hemodynamics, postoperative pain, rescue analgesia, complications, and time to ambulation were assessed. Results: Baseline demographics were comparable between groups. EA achieved faster sensory onset (p < 0.001), shorter block performance time ( p < 0.001), higher surgical success (p < 0.001), lower intraoperative pain (p < 0.001), greater surgeon satisfaction (p < 0.001), and fewer conversions to general anesthesia (p < 0.001). Motor block was also superior (p < 0.001). Hemodynamic parameters remained stable with no significant group differences. Postoperative analgesic requirements, time to first rescue dose (p = 0.136), total consumption (p = 0.309), and complication rates (p = 0.309) were comparable. VAS pain scores were similar at 2–12 hours but lower with EA at 18 (p < 0.001) and 24 hours (p < 0.001). Conclusion: Epidural anesthesia provided more reliable surgical anesthesia, greater surgeon satisfaction, and prolonged postoperative analgesia, whereas paravertebral block facilitated earlier ambulation but had a higher failure rate. Epidural anesthesia remains the more dependable technique for open inguinal hernia repair.