Factores asociados al dolor crónico posoperatorio en pacientes llevados a herniorrafia inguinal

Abstract

Introduction: Groin herniorhaphy is related to chronic postoperative pain (CPP) up to 50% of cases, and in some of them it can be disabling. In this study CPP related factors were evaluated in patients carried to groin hernia repair. Methodology: A multicenter cohort study was conducted. Sociodemographic and personal background information was considered. Ocurrence and intensity of acute postoperative pain (APP) were assesed, and CPP related factors were analyzed with a follow up performed at the two months postoperative point. Chi-square test correlations were established. With lineal regression we evaluated the real role of confussion factors. Results: 108 patients were analyzed. 54.7% showed CPP. Age under 40 years, uncontrolled APP, severe APP, and uncontrolled pain between first and third postoperative weeks, were related to increased risk of CPP. In age over 65, intrathecal opioid administration, visualisation and preservation of nerves during surgery, and the use of three or more intravenous analgesics plus ilioinguinal/iliohypogastric block were protector factors. Discusion: El CPP is frequent in our environment. Prevention and efficient management of APP by using multimodal analgesia, the use of intrathecal opioids, and the identification and preservation of nerves during surgery enhance CPP prevention. Similar studies, performed at a larger scales, will allow the identification of other related factors to this pathology.