Avaliação da dor pós-operatória e alta hospitalar com bloqueio dos nervos ilioinguinal e ílio-hipogástrico durante herniorrafia inguinal realizada com raquianestesia: estudo prospectivo

Santos, Guilherme de Castro; Braga, Gisela Magalhães; Queiroz, Fábio Lopes de; Navarro, Túlio Pinho; Gomez, Renato Santiago

doi:10.1590/s0104-42302011000500013

Cited by 9 publications

(4 citation statements)

References 21 publications

(19 reference statements)

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“…Despite the analgesia protocol used, the average pain on the first postoperative day was 4.79 at VAS, with 5 patients reporting 10/10 pain in the same period. This result corroborates with that indicated by Santos et al, 2015, that the use of analgesics, nonsteroidal anti-inflammatory drugs, and opioids in the immediate postoperative period does not seem to be fully effective in preventing and treating pain the day after inguinal hernia surgery [15 ]. The average pain intensities, according to VAS, on the 30th, 90th, and 180th postoperative days were 2.66, 2.05, and 1.92, respectively.…”

Section: Discussionsupporting

confidence: 90%

Evaluation of postoperative pain in patients undergoing unilateral inguinal hernioplasty by Lichtenstein

Ferreira¹,

Franciss²

2023

Int J Clin Res

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Background: Lichtenstein's surgery is the most recommended technique in the treatment of unilateral inguinal hernias in men, due to its simplicity, speed, pain-free, and almost unrestricted return to physical activities. The evidence indicates that work and leisure activities can be resumed, by most patients, in three to five days after laparoscopic or conventional hernioplasties, without the risk of recurrences or complications. Nevertheless, chronic pain is the most common postoperative complication affecting about 30% of patients regardless of the surgical technique used. Predictive factors for chronic pain are young age, female gender, preoperative pain level, and postoperative pain intensity. Aim: To evaluate the perception of postoperative pain in patients who have undergone unilateral elective inguinal hernioplasty using the Lichtenstein technique in order to define predictors of the development of chronic pain and to identify the average time to return to work and to normal physical activity. Methods: Analysis of electronic forms applied to patients that underwent elective unilateral inguinal hernia repair by Lichtenstein at a state hospital in a small town in the interior of Brazil. The statistical analyses were processed using the software Statistical Package for Social Sciences (SPSS) version 22.0. Results: Data from 38 participants were analyzed with an average of 41.45 (± 13.94) years. Most of them returned to work and to light physical activities 45 days after surgery. There was a positive correlation between the presence of pain 90 days after surgery and the development of chronic pain (Spearman correlation of 0,818 and p < 0.001). Conclusion: Despite the small sample of this study, it awakens us to the consequences that Lichtenstein surgery can trigger for patients with inguinal hernia and the importance of good management and evaluation of postoperative pain in order to improve the quality of life of these patients.

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Section: Discussionsupporting

confidence: 90%

Evaluation of postoperative pain in patients undergoing unilateral inguinal hernioplasty by Lichtenstein

Ferreira¹,

Franciss²

2023

Int J Clin Res

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“…Despite the great advances in the surgery, the treatment of postoperative pains remains a major problem. Any factor that causes the patient to use less narcotic pain medication and to move sooner would be beneficial to patients and society 6. Some studies suggest that propofol-based anesthesia can lead to less postoperative pain than other anesthetics 3.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, opioid drugs may be inappropriate to relieve pain at any dose level without respiratory depression, unbearable nausea, itching, and constipation 45. In addition, inadequate pain treatment is related to prolonged hospitalization, more intense pain and increased health care costs 6. Anesthesia is a temporary and short-term situation that can result in consequences after recovery.…”

Section: Introductionmentioning

confidence: 99%

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Effect of intravenous anesthesia with propofol versus isoflurane inhalation anesthesia in postoperative pain of inguinal herniotomy: a randomized clinical trial

et al. 2017

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Postoperative pain is a common problem after inguinal herniotomy. We aimed to compare the intravenous anesthesia effects of propofol and isoflurane inhalation anesthesia on postoperative pain after inguinal herniotomy. In a randomized clinical trial, 102 eligible patients were selected based on inclusion and exclusion criteria and were randomly divided in two groups. In the first group, propofol was used for the maintenance of anesthesia, while isoflurane was used in the second group. The patient’s heart rate, systolic and diastolic blood pressure and oxygen saturation before, during and after surgery, recovery time and postoperative pain were measured immediately, 2, 4 and 6 hours after surgery and compared between two groups. T-test, and repeated measurement test were used for statistical analysis. No statistically significant differences were observed in heart rate, blood pressure and oxygen saturation levels between the two groups (P > 0.05). Propofol has higher effect in easing postoperative pain of patients than isoflurane, but no difference in postoperative complications, including chills, nausea and vomiting, occurs in both two groups. Propofol is effective in declining the postoperative pain of patients after anesthesia in comparison with isoflurane. Moreover, due to the antioxidant, anti-inflammatory and analgesic properties of propofol, it is preferred to isoflurane and the authors recommended it to be used.

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International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,315

581

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IntroductionWorldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery.MethodsAn expert group of international surgeons (the HerniaSurge Group) and one anesthesiologist pain expert was formed. The group consisted of members from all continents with specific experience in hernia-related research. Care was taken to include surgeons who perform different types of repair and had preferably performed research on groin hernia surgery. During the Group’s first meeting, evidence-based medicine (EBM) training occurred and 166 key questions (KQ) were formulated. EBM rules were followed in complete literature searches (including a complete search by The Dutch Cochrane database) to January 1, 2015 and to July 1, 2015 for level 1 publications. The articles were scored by teams of two or three according to Oxford, SIGN and Grade methodologies. During five 2-day meetings, results were discussed with the working group members leading to 136 statements and 88 recommendations. Recommendations were graded as “strong” (recommendations) or “weak” (suggestions) and by consensus in some cases upgraded. In the Results and summary section below, the term “should” refers to a recommendation. The AGREE II instrument was used to validate the guidelines. An external review was performed by three international experts. They recommended the guidelines with high scores.Results and summaryThe risk factors for inguinal hernia (IH) include: family history, previous contra-lateral hernia, male gender, age, abnormal collagen metabolism, prostatectomy, and low body mass index. Peri-operative risk factors for recurrence include poor surgical techniques, low surgical volumes, surgical inexperience and local anesthesia. These should be considered when treating IH patients. IH diagnosis can be confirmed by physical examination alone in the vast majority of patients with appropriate signs and symptoms. Rarely, ultrasound is necessary. Less commonly still, a dynamic MRI or CT scan or herniography may be needed. The EHS classification system is suggested to stratify IH patients for tailored treatment, research and audit. Symptomatic groin hernias should be treated surgically. Asymptomatic or minimally symptomatic male IH patients may be managed with “watchful waiting” since their risk of hernia-related emergencies is low. The majority of these individuals will eventually require surgery; therefore, surgical risks and the watchful waiting strategy should be discussed with patients. Surgical treatment s...

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Avaliação da dor pós-operatória e alta hospitalar com bloqueio dos nervos ilioinguinal e ílio-hipogástrico durante herniorrafia inguinal realizada com raquianestesia: estudo prospectivo

Abstract: II and IH nerve block associated with surgical wound infiltration with 0.75% ropivacaine provides better postoperative analgesia and early hospital discharge in patients undergoing inguinal hernia repair under spinal anesthesia.

Cited by 9 publications

References 21 publications

Evaluation of postoperative pain in patients undergoing unilateral inguinal hernioplasty by Lichtenstein

Evaluation of postoperative pain in patients undergoing unilateral inguinal hernioplasty by Lichtenstein

Effect of intravenous anesthesia with propofol versus isoflurane inhalation anesthesia in postoperative pain of inguinal herniotomy: a randomized clinical trial

International guidelines for groin hernia management

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