Predictors of chronic pain after laparoscopic inguinal hernia repair

Forester, Beau; Attaar, Mikhail; Chirayil, Sebastian; Kuchta, Kristine; Denham, Woody; Linn, John G.; Ujiki, Michael

doi:10.1016/j.surg.2020.07.049

Cited by 17 publications

(8 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results show that age is a risk factor for chronic pain, with younger patients (<40 years) reporting increased pain levels compared to older patients, regardless of the repair technique 19–21 . Similar results were found in studies that solely investigated mesh techniques, indicating that the presence of mesh may not be the cause of pain following groin hernia repair 30,31 . Other influencing factors not captured by the present study include preoperative pain, surgical technique (open or laparoscopic), surgery for recurrence and nerve injury 32 …”

Section: Discussionsupporting

confidence: 80%

“…19 , 20 , 21 Similar results were found in studies that solely investigated mesh techniques, indicating that the presence of mesh may not be the cause of pain following groin hernia repair. 30 , 31 Other influencing factors not captured by the present study include preoperative pain, surgical technique (open or laparoscopic), surgery for recurrence and nerve injury. 32 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mesh versus non‐mesh repair of groin hernias: a rapid review

Smith

Khoja

Jacobsen

et al. 2022

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: Mesh is frequently utilized intraoperatively for the repair of groin hernias. However, patients may request non-mesh hernia repairs owing to adverse events reported in other mesh procedures. To inform surgical safety, this study aimed to compare postoperative complications between mesh and non-mesh groin hernia repairs and identify other operative and patient-related risk factors associated with poor postoperative outcomes. Methods: Ovid MEDLINE and grey literature were searched to 9 June 2021 for studies comparing mesh to non-mesh techniques for primary groin hernia repair. Outcomes of interest were postoperative complications, recurrence of hernia, pain and risk factors associated with poorer surgical outcomes. Methodological quality was appraised using the AMSTAR 2 tool. Results: The systematic search returned 4268 results, which included seven systematic reviews and five registry analyses. Mesh repair techniques resulted in lower hernia recurrence rates, with no difference in chronic pain, seroma, haematoma or wound infection, compared to non-mesh techniques. Risk factors associated with increased risk of hernia recurrence were increased body mass index (BMI), positive smoking status and direct hernia. These were independent of surgical technique. Patients under 40 years of age were at increased risk of postoperative pain. Conclusions: Surgical repair of primary groin hernias using mesh achieves lower recurrence rates, with no difference in safety outcomes, compared with non-mesh repairs. Additional risk factors associated with increased recurrence include increased BMI, history of smoking and hernia subtype.

show abstract

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Mesh versus non‐mesh repair of groin hernias: a rapid review

Smith

Khoja

Jacobsen

et al. 2022

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Although the incidence of pain in laparoscopic inguinal hernia repair is lower than that of traditional open surgery, the incidence of postoperative chronic pain is 12.7%, of which 83.3% of patients’ pain is located in the groin area. [ 18 ] The occurrence of pain is related to mesh size, whether the mesh is mechanically fixed, bleeding and infection at the surgical site, etc. [ 19 ] .…”

Section: Discussionmentioning

confidence: 99%

Effect of ketorolac tromethamine combined with dezocine prior administration on hemodynamics and postoperative analgesia in patients undergoing laparoscopic hernia repair

Wu¹,

Cai²,

Li³

et al. 2022

Medicine

View full text Add to dashboard Cite

Objective: To observe the effect of Ketorolac tromethamine combined with dezocine prior administration on hemodynamics and postoperative sedation in patients undergoing laparoscopic hernia repair. Methods: 100 male patients aged 60 to 80 years old, a line to elective laparoscopic inguinal hernia repair, were randomly divided into four groups: control group (Group A) and dezocine group (Group B), ketorolac tromethamine group (Group C), ketorolac tromethamine combined with dezocine group (Group D). Patients were administrated with 0.1 mg/kg dezocine in Group B, 0.5 mg/kg ketorolac in Group C, 0.1 mg/kg dezocine, and 0.5 mg/kg ketorolac in Group D, and with an equal dose of normal saline in group A. The heart rate (HR) and mean arterial pressure (MAP) of patients in 4 groups were recorded at each time point as follows, T0 (enter the operating room), T1 (before skin resection), 10 min after pneumoperitoneum (T2), mesh placement (T3), and laryngeal mask extraction (T4). Operation time, awakening time (time from drug withdrawal to consciousness recovery), the dosage of propofol, sufentanil, remifentanil, and intraoperative vasoactive drug dosage were recorded to compare. Visual analog scale score and sedation Ramsay score were evaluated 1, 6, 12, and 24 hours after extubation. Results: There was no significant difference in operation time, anesthesia recovery time, sufentanil dosage, and vasoactive drugs among all groups. The amount of propofol in Group B and D was less than that in Group A and C ( P < .05), and there was no difference between Group B and D, A and C ( P > .05). The amount of remifentanil in Group B, C, and D was less than that in Group A ( P < .05), and Group D was less than B and C ( P < .05). After extubation, HR and MAP were significantly higher than before ( P < .05). Compared with T0, HR and MAP increased in each group at T4, but MAP and HR in Group D increased the least ( P < .05). There were significant differences between Group B, C, D, and A, MAP and HR fluctuated little during extubation ( P < .05), but there was a significant difference between Group D and B, C ( P < .05). Visual analog scale scores of Group B, C, and D were lower than those of A at 1, 6, and 12 hours after surgery ( P < .05), and there was a significant difference between Group D, and B, C ( P < .05). Ramsay scores in Group B and D were higher than those in A and C at 1 and 6 hours after the operation ( P < .05). There was no difference in the incidence of adverse reactions among groups. Conclusion: The prophylactic use of ketorolac tromethamine and dezocine before laparoscopic inguinal hernia repair can reduc...

show abstract

“…However, young age has been demonstrated as a known predictor for chronic pain. 38 Fourth, a proportion of intraoperative data was missing which could not be adjusted for, leading to a small sample size to assess hernia fixation location. However, our study was initially powered to assess the main outcome of postoperative pain, and was not powered to assess secondary outcomes.…”

Section: Discussionmentioning

confidence: 99%

Cyanoacrylate Glue Versus Absorbable Tacks in Mesh Fixation for Laparoscopic Extraperitoneal Inguinal Hernia Repair: A Randomized Controlled Trial

Issa¹,

Tacey

Geraghty³

et al. 2021

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

View full text Add to dashboard Cite

Background: Cyanoacrylate glue (Glubran 2) is a synthetic adhesive mesh fixation material. Its utility is being evaluated in laparoscopic total extraperitoneal (TEP) inguinal hernia repair (IHR). A multicentre randomized controlled trial was performed comparing Glubran 2 to standard of care absorbable tacks, particularly assessing chronic postoperative inguinal pain and its effects.Materials and Methods: Patients undergoing elective TEP IHR at 2 centers from 2017 to 2019 were randomly assigned to Glubran 2 or absorbable tack mesh fixation, and followed for 6 months. All other aspects of surgery and aftercare remained the same. Surgeons documented operative and fixation time, and the placement of fixation on standardized diagrams. Via a questionnaire, aspects of inguinal pain were evaluated before surgery, and at various timepoints postoperatively over 6 months. Postoperative clinical factors were also collected.Results: A total of 106 operative sides were randomized to either glue (51) or tack (55) mesh fixation over a 14-month period. Similar median operative times between tack (83.0 min) and glue fixation (75.0 min) were observed. There were no significant surgical complications or observed hernia recurrences in either group. There was no significant difference in pain scores between the 2 groups at all time-points after analysis through mixed effects modeling. Temporal pain profiles over time were also similar. Totally, 55% of patients in the glue group had returned to work within 2 weeks of surgery. There was no increase in complications or pain scores despite regular lateral fixation of glue in these patients. Conclusion:Adding to known data, we observed no significant difference in postoperative pain, demonstrating that cyanoacrylate glue is a viable and safe alternative fixation method to absorbable tacks in laparoscopic TEP IHR. As secondary outcomes, cyanoacrylate glue permits some patients to return to work early, and we observed regular lateral mesh glue fixation without increased pain or complications.

show abstract

Predictors of chronic pain after laparoscopic inguinal hernia repair

Cited by 17 publications

References 20 publications

Mesh versus non‐mesh repair of groin hernias: a rapid review

Mesh versus non‐mesh repair of groin hernias: a rapid review

Effect of ketorolac tromethamine combined with dezocine prior administration on hemodynamics and postoperative analgesia in patients undergoing laparoscopic hernia repair

Cyanoacrylate Glue Versus Absorbable Tacks in Mesh Fixation for Laparoscopic Extraperitoneal Inguinal Hernia Repair: A Randomized Controlled Trial

Contact Info

Product

Resources

About