Chronic pain after groin hernia repair : pain characteristics and impact on quality of life
Bande, David (Institut Hospital del Mar d'Investigacions Mèdiques)
Moltó, Luis (Institut Hospital del Mar d'Investigacions Mèdiques)
Pereira-Rodríguez, J. A. (Institut Hospital del Mar d'Investigacions Mèdiques)
Montes, Antonio (Institut Hospital del Mar d'Investigacions Mèdiques)
Universitat Autònoma de Barcelona

Data:	2020
Resum:	Chronic postsurgical pain (CPSP) after hernia repair research has mainly relied on unconfirmed self-reporting. We aimed to describe confirmed CPSP incidence, management, and quality of life (QoL) in a 2-year prospective study. Multicenter study (GENDOLCAT) of 3890 patients undergoing 4 common surgical procedures in 23 hospitals to develop a risk model for CPSP; 2352 men underwent open hernia repair. Patients with pain were identified by telephone at 1 and 3 months and referred to the hospital 4 months after surgery for a physical examination to confirm CPSP. Three validated tools were used: the Brief Pain Inventory (BPI) for severity, analgesic use, and interference with activities; the SF-12 questionnaire for QoL (validated Spanish version), and the Douleur Neuropathique 4 (DN4). Patients with CPSP were called again at 1 and 2 years. In 1761 patients who underwent hernia repair and were eligible for physical examination for CPSP, the incidence of confirmed pain at 4 months was 13. 6% (patient-reported pain, 6. 2% at 1 year and 4. 0% at 2 years). Neuropathic pain was diagnosed in 38. 5% of the CPSP patients at 4 months. The incidences of neuropathic CPSP in patients with mesh or non-mesh repairs were similar (38. 6 and 33. 3%, respectively). SF-12 physical component scores changed little in all patients, whether or not they developed CPSP. The SF-12 mental component decreased significantly in all patients, but the decrease was clinically significant only in CPSP patients. CPSP interfered with activities (18%), work (15. 6%), walking (15%) and mood (10. 2%). At 2 years 52. 1% of CPSP patients had moderate/intense pain and 28. 2% took analgesics. CPSP affects QoL-related activities, and although it diminishes over the course of 2 years after surgery, many patients continue to have moderate/intense pain and take analgesics. CPSP and neuropathic pain rates seem to be similar after mesh and non-mesh repair. BPI and SF-12 mental component scores detect effects on QoL. NCT01510496.
Nota:	Altres ajuts: This study was financially supported by grant 071210-2007 from Fundació La Marató de TV3 (Catalan public television network Marathon Foundation, Barcelona, Spain).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Chronic pain ; Hernia repair ; Quality of life
Publicat a:	BMC Surgery, Vol. 20 (july 2020) , ISSN 1471-2482

DOI: 10.1186/s12893-020-00805-9
PMID: 32631293

11 p, 1.2 MB

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