Chronic Pain After Inguinal Hernia Repair

Kehlet, Henrik; Aasvang, Eske Kvanner

doi:10.1007/978-3-642-11541-7_21

Cited by 6 publications

(6 citation statements)

References 18 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In conclusion, we did not find pre-operative pain from groin hernias to be associated with sensory alterations that can explain the observation of pre-operative pain to be a risk factor for developing persistent pain. Several other mechanisms than pre-operative pain-mediated neuroplastic changes may therefore contribute to the development of a persistent postherniotomy pain state (young age, pain at other sites of the body, intraoperative nerve damage, intense acute post-operative pain, genetics) (Kehlet et al, 2006;Kehlet, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…Despite the fact that groin herniotomy is one of the most frequently performed surgical procedures, the pathogenic mechanisms leading to persistent pain in 5-10% of patients remain unclear (Kehlet, 2008). So far, several studies have shown that sensory disturbances occur in postherniotomy pain patients as well as pain-free patients (Mikkelsen et al, 2004;Cunningham et al, 1996;Nienhuijs et al, 2007;Aasvang et al, 2007Aasvang et al, , 2008, implying that nerve damage is a necessary but not sufficient factor for development of persistent pain.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pre-operative pain and sensory function in groin hernia

Aasvang

Hansen

Kehlet

2009

European Journal of PainHas erratum 2016-10-24

View full text Add to dashboard Buy / Rent full text

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pre-operative pain and sensory function in groin hernia

Aasvang

Hansen

Kehlet

2009

European Journal of PainHas erratum 2016-10-24

View full text Add to dashboard Buy / Rent full text

show abstract

“…Chronic pain lasting more than a year after surgery has been established as the most serious adverse outcome after inguinal herniotomy, affecting daily activities in about 10% of patients several years after surgery (Kehlet, 2008). These patients show signs of nerve injury (increased detection thresholds for tactile and warmth stimulation and decreased detection thresholds for cold and pressure pain), as evidenced by quantitative sensory testing.…”

Section: Introductionmentioning

confidence: 99%

A positron emission tomography study of wind-up pain in chronic postherniotomy pain

Kupersl

Lonsdalel

Aasvangl

et al. 2011

European Journal of Pain

View full text Add to dashboard Buy / Rent full text

Many neuropathic pain conditions are characterized by abnormal responses to noxious or innocuous mechanical stimulation, including wind-up pain. Whereas previous brain imaging studies have explored the cerebral correlates of hyperalgesia and allodynia, no studies are available on mechanical-induced wind-up pain in neuropathic pain patients. We therefore used positron emission tomography (PET) to investigate the cerebral response pattern of mechanical wind-up pain in a homogenous group of 10 neuropathic pain patients with long-standing postherniotomy pain in the groin area. Patients were scanned in the following conditions: (1) rest; (2) wind-up pain, induced by 2 Hz von Frey stimulation in the painful area; (3) non-painful 2 Hz von Frey stimulation in the homologous contralateral area and (4) tonic pressure pain in the homologous contralateral area. A direct comparison between wind-up pain and non-painful von Frey stimulation revealed that the former more strongly activated contralateral secondary somatosensory cortex, insula, anterior cingulate cortex, right dorsolateral prefrontal cortex, thalamus and cerebellum. In addition, wind-up pain also activated the sublenticular extended amygdala (SLEA) and the brain stem. A direct comparison between wind-up pain and pressure pain revealed that both activated a largely overlapping network. Since no de novo brain areas were activated by wind-up pain, our data suggest that the processes specific to wind-up pain do not occur at the cerebral level.

show abstract

“…It has been reported that ALA exhibits an antiinflammatory effect on both acute and chronic inflammations (Odabasoglu et al 2011). Many of the long-term complications occur as a consequence of a foreign-body reaction induced by implantation of non-absorbable mesh (Kumar et al 2002;Kehlet 2008). Therefore, controlling the tissue inflammatory response after mesh implantation may decrease the expected complications.…”

Section: Discussionmentioning

confidence: 99%

Effect of alpha lipoic acid co-administration on structural and immunohistochemical changes in subcutaneous tissue of anterior abdominal wall of adult male albino rat in response to polypropylene mesh implantation

Mazroa

Asker

et al. 2015

Int. J. Exp. Path.

View full text Add to dashboard Buy / Rent full text

Polypropylene mesh is commonly used in the treatment of abdominal hernia. Different approaches were addressed to improve their tissue integration and consequently reduce long-term complications. This study aimed to investigate the effect of alpha-lipoic acid (ALA) co-administration on structural and immunohistochemical (IHC) changes in the subcutaneous tissues of the anterior abdominal wall of the adult rat in response to polypropylene mesh implantation. Forty adult male albino rats were divided into: group I (control), group II (receiving ALA), group III (polypropylene mesh implantation) and group IV (mesh implantation + ALA co-administration). After 4 weeks, subcutaneous tissue samples were prepared for light microscopy and IHC study of CD34 as a marker for angiogenesis. In groups I and II rats, positive CD34 expression was demonstrated by IHC reaction, localized to endothelial cells lining small blood vessels. Group III showed an excess inflammatory reaction, deposition of both regular and irregularly arranged collagen fibres around mesh pores and few elastic fibres. CD34-positive was detected not only in cells lining small blood vessels but also in other cells scattered in the connective tissue indicating angiogenesis. In group IV, ALA co-administration resulted in less inflammatory reaction, regular collagen deposition, enhanced elastic fibres synthesis and a significant increase in CD34-positive cells and small blood vessels reflecting improved angiogenesis. ALA co-administration with polypropylene mesh implantation controlled the inflammatory reaction, helped regular collagen deposition, enhanced elastic fibres synthesis and improved angiogenesis in the subcutaneous tissue of anterior abdominal wall of adult albino rats, suggesting a possible role of ALA in optimizing mesh integration in subcutaneous tissue.

show abstract

Chronic Pain After Inguinal Hernia Repair

Cited by 6 publications

References 18 publications

Pre-operative pain and sensory function in groin hernia

Pre-operative pain and sensory function in groin hernia

A positron emission tomography study of wind-up pain in chronic postherniotomy pain

Effect of alpha lipoic acid co-administration on structural and immunohistochemical changes in subcutaneous tissue of anterior abdominal wall of adult male albino rat in response to polypropylene mesh implantation

Contact Info

Product

Resources

About