Incidence of chronic post-surgical pain and its associated factors in patients taken to inguinal hernia repair
Abstract
Introduction:
In up to 50% of cases, inguinal hernia repair is associated with chronic post-surgical pain, which can be a cause of disability in a proportion of patients.
Objective:
To estimate the incidence of chronic post-surgical pain and its associated factors in patients taken to inguinal hernia repair.
Materials and methods:
Observational follow-up study in a cohort of patients. Social, demographic and personal background information was obtained; the incidence and intensity of acute and chronic post-operative pain was determined; and the factors associated with the development of chronic pain were evaluated. Associations were determined in accordance with the nature of the variables. A linear regression was used to assess the role of confounding factors.
Results:
Overall, 108 patients were analysed, and of them, 27.8% (n = 30) had chronic post-surgical pain. The multivariate analysis showed that the use of general anaesthesia and uncontrolled pain 15 days after surgery were associated with a higher risk of developing this condition. In contrast, diclofenac administration was protective.
Discussion:
Chronic post-surgical pain is frequent in this type of surgery. According to this study, the use of peri-operative analgesia together with pain prevention and management within the first post-operative weeks help prevent the development of chronic post-surgical pain. General anaesthesia may increase the risk. Similar studies conducted at a larger scale could help identify other associated factors.
References
2. Deumens R, Steyaert A, Forget P, Schubert M, Lavand'homme P, Hermans E, et al. Prevention of chronic postoperative pain: cellular, molecular, and clinical insights for mechanism-based treatment approaches. Prog Neurobiol. 2013;104:1-37.
3. Werner M, Kongsgaard UI. Defining persistent post-surgical pain: is an update required? Br J Anaesth. 2014;113:H
4. Callesen T, Bech K, Kehlet H. Prospective study ofchronic pain after groin hernia repair. Br J Surg. 1999;86:1528-31.
5. Rabat E. Dolor croííico como resultado adverso de la cirugia. II Parte: colecistectomia y hernioplastia inguinal. Rev Iberoamericana del Dolor. 2007;3:20-5.
6. Hawn MT, Itani KM, Giobbie-Hurder A, McCarthy M, Jonasson O, Neumayer LA. Patient-reported outcomes after inguinal herniorrhaphy. Surgery. 2006;140:198-205.
7. Aasvang E, Kehle H. Surgical management of chronic pain after inguinal hernia repair. Br J Surg. 2005;92:795-801.
8. Poobalan A, Bruce J, King P, Chambers W, Krukowski Z, Smith W. Chronic pain and quality of life following open inguinal hernia repair. Br J Surg. 2001;88:1122-6.
9. Ali SM, Zendejas B, Yadav S, Hernandez-Irizarry RC, Lohse CM, Farley DR. Predictors of chronic groin discomfort after laparoscopic totally extraperitoneal inguinal hernia repair. J Am Coll Surg. 2013;217:72-8.
10. Franneby U, Sandblom G, Nordin P, Nyrén O, Gunnarsson U. Risk factors for long-term pain after hernia surgery. Ann Surg. 2006;244:212-9.
11. Alfieri S, Amid P, Campanelli G, Izard G, Kehlet H, Wijsmuller A, et al. International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery. Hernia. 2011;15:239-49.
12. Schmedt C, Sauerland S, Bittner R. Comparison ofendoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis ofrandomized controlled trials. Surg Endosc. 2005;19:188-99.
13. Sajid MS, Kalra L, Parampalli U, Sains PS, Baig MK. A systematic review and meta-analysis evaluating the effectiveness of lightweight mesh against heavyweight mesh in influencing the incidence of chronic groin pain following laparoscopic inguinal hernia repair. Am J Surg. 2013;205:726-36.
14. Callesen T. Inguinal hernia repair: anaesthesia, pain and convalescence. Dan Med Bull. 2003;50:203-18.
15. Hansen MB, Andersen KG, Crawford ME. Pain following the repair of an abdominal hernia. Surg Today. 2010;40:8-21.
16. Brandsborg B, Nikolajsen L, Hansen CT, Kehlet H, Jensen TS. Risk factors for chronic pain after hysterectomy: a nationwide questionnaire and database study. Anesthesiology. 2007;106:1003-12.
17. Nikolajsen L, S0rensen H, Jensen TS, Kehlet H. Chronic pain following Caesarean section. Acta Anaesthesiol Scand. 2004;48:111-6.
18. Sadatsune EJ, Leal PdC, Clivatti J, Sakata RK. Dor crónica pós-operatória: fisiopatologia, fatores de risco e prevenirão. Rev Dor. 2011;12:58-63.
19. Badiola IJ. Can chronic pain be prevented? Anesthesiol Clin. 2016;34:303-15.
20. Clarke H, Poon M, Weinrib A, Katznelson R, Wentlandt K, Katz J. Preventive analgesia and novel strategies for the prevention of chronic post-surgical pain. Drugs. 2015;75:339-51.
21. Ladha KS, Patorno E, Huybrechts KF, Liu J, Rathmell JP, Bateman BT. Variations in the use of perioperative multimodal analgesic therapy. Anesthesiology. 2016;124:837-45.
Downloads
Altmetric
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
