TY - JOUR
T1 - Pain after primary inguinal herniorrhaphy
T2 - Influence of surgical technique
AU - Callesen, Torben
AU - Bech, Karsten
AU - Andersen, Jens
AU - Nielsen, Rolf
AU - Roikjaer, Ole
AU - Kehlet, Henrik
PY - 1999/4/1
Y1 - 1999/4/1
N2 - Background: Pain is an important problem after ambulatory hernia repair. To assess the influence of the surgical technique on postoperative pain, two separate randomized, patient-blinded, controlled trials were performed in men with an indirect inguinal hernia. Study Design: In study A, 48 patients with an internal inguinal ring smaller than 1.5 cm were randomly allocated to either simple extirpation of the hernial sac or extirpation plus annulorrhaphy. In study B, 84 patients with an internal inguinal ring wider than 1.5 cm were randomly allocated to extirpation plus annulorrhaphy or extirpation plus Lichtenstein mesh repair (modified). All operations were performed under unmonitored local anesthesia with standardized perioperative analgesia using methadone and tenoxicam. Pain was scored daily for the first postoperative week and after 4 weeks on a four-point verbal-rank scale (no, light, moderate, or severe pain) during rest, while coughing, and during mobilization (rising to the sitting position). Use of supplementary analgesics (paracetamol) was recorded. Cumulative daily pain scores for the first postoperative week and the number of patients who used supplementary analgesics were the main outcome measures. Results: There were no significant differences in cumulative pain scores or use of supplementary analgesics between the treatment groups in either study. Cumulative pain scores were significantly higher during coughing and mobilization than during rest in both studies. Conclusions: Choice of surgical technique for open repair of a primary indirect inguinal hernia has no influence on postoperative pain.
AB - Background: Pain is an important problem after ambulatory hernia repair. To assess the influence of the surgical technique on postoperative pain, two separate randomized, patient-blinded, controlled trials were performed in men with an indirect inguinal hernia. Study Design: In study A, 48 patients with an internal inguinal ring smaller than 1.5 cm were randomly allocated to either simple extirpation of the hernial sac or extirpation plus annulorrhaphy. In study B, 84 patients with an internal inguinal ring wider than 1.5 cm were randomly allocated to extirpation plus annulorrhaphy or extirpation plus Lichtenstein mesh repair (modified). All operations were performed under unmonitored local anesthesia with standardized perioperative analgesia using methadone and tenoxicam. Pain was scored daily for the first postoperative week and after 4 weeks on a four-point verbal-rank scale (no, light, moderate, or severe pain) during rest, while coughing, and during mobilization (rising to the sitting position). Use of supplementary analgesics (paracetamol) was recorded. Cumulative daily pain scores for the first postoperative week and the number of patients who used supplementary analgesics were the main outcome measures. Results: There were no significant differences in cumulative pain scores or use of supplementary analgesics between the treatment groups in either study. Cumulative pain scores were significantly higher during coughing and mobilization than during rest in both studies. Conclusions: Choice of surgical technique for open repair of a primary indirect inguinal hernia has no influence on postoperative pain.
UR - http://www.scopus.com/inward/record.url?scp=0032907867&partnerID=8YFLogxK
U2 - 10.1016/S1072-7515(98)00316-0
DO - 10.1016/S1072-7515(98)00316-0
M3 - Journal article
C2 - 10195718
AN - SCOPUS:0032907867
SN - 1072-7515
VL - 188
SP - 355
EP - 359
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 4
ER -