Significant factors influencing chronic postoperative inguinal pain: A conditional time-dependent observational cohort study

Abstract

Background: Inguinal hernia (IH) repair is a common surgical procedure. Focus has shifted from recurrences to chronic postoperative inguinal pain (CPIP). To assess the natural course of CPIP and identify patient factors influencing the onset of CPIP, an observational registry-based study was performed. Materials and methods: Data prospectively collected from the Club-Hernie national database was retrieved from 2011 until 2021. Patients who underwent elective surgery for inguinal hernia were divided in an irrelevant pain group and relevant pain group. Relevant pain at one year and two years were compared with patients with irrelevant pain at all-time points (preoperatively, one month, one year and two years). Quality of life questions were compared between relevant pain at one year and two years. Results: 4.016 patients were included in the analysis. Mean age was 65.1 years, 90.3% of patients was male. Factors correlated with CPIP onset were age, gender, ASA, recurrent surgery, surgical technique, nerve handling and fixation type. Relevant pain at one month was a greater risk for CPIP than preoperative pain (12.3% vs 3.6%). In the majority of patients (83.2%) CPIP was ameliorated at two years. Hernia related complaints differed significantly between CPIP at one year and two years. Conclusion: Postoperative pain after one month was a greater risk factor for CPIP development than preoperative pain. CPIP at one year seems to have a different pain etiology than CPIP at two years. Patient and surgical factors influence the onset of CPIP at one year, however the natural course of these complaints shows great decline at two years, largely without reinterventions.

Change in perioperative neutrophil-lymphocyte ratio as a potential predictive biomarker for chronic postsurgical pain and quality of life: an ambispective observational cohort study

“…However, female sex and higher BMI were not independent risk factors for CPSP, and CPSP was more apparent in older age in this study. Our univariate analysis confirmed the results of previous studies that open surgery, higher ASA score, and longer surgery duration are risk factors for CPSP ( 4 , 46 ).…”

Quadratus lumborum block versus transversus abdominis plane block for inguinal hernia repair: A systematic review and meta‐analysis with trial sequential analysis

“…7 In the presence of risk factors such as existing preoperative pain, the use of preoperative analgesics, gender, age, and an already compromised quality of life, acute postoperative pain can lead to chronic pain. [8][9][10][11] Regional blocks have been theorized to halt this progression by impeding pain impulse transmission and preventing central sensitization and subsequent chronic neuropathic pain. 12,13 The reliance on opioids for postoperative pain is a concern.…”