A Comparative Evaluation of General Anesthesia versus Spinal Anesthesia Combined with Paravertebral Block for Renal Surgeries: A Randomized Prospective Study

Background: General anesthesia with endotracheal intubation has remained the most common technique used for open renal surgeries because of the abnormal body position and its ability to control the diaphragmatic movement during the surgery. Combined spinal and thoracic paravertebral block (TPVB) can be used as alternative technique for open renal surgery, where spinal anesthesia provides fast and reliable to start the surgery and the duration of anesthesia can be extended with a catheter in the paravertebral space. Aim of the work: To compare general anesthesia versus combined spinal/paravertebral block in patients undergoing open renal surgeries Patients and methods: The patients were classified according to anesthetic technique into two groups as follow: Group I: include 50 patients received combined spinal/ paravertebral block. Group II: include 50 patients received general anesthesia. Measurements: -HR and MABP Surgeon satisfaction Patient satisfaction Postoperative analgesia -The time to first dose of analgesiaSide effects such as nausea and vomiting, and shivering were noted. Results: The MABP and HR were increased significantly in group II after intubation while it maintained stable in group I. The Time to first analgesic request was statistically significant longer in group I than group II. No significant differences were found as regards to surgeon's satisfaction between both groups. The patient's satisfaction was better in group I. The incidences of side effects were higher in group II than group I. Conclusion: Combined spinal and paravertebral block can be safely and effectively used in patients undergoing open renal surgeries.