A national center for persistent severe pain after groin hernia repair : Five-year prospective data

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Jensen, Elisabeth KjærCopenhagen University Hospital (author)

A national center for persistent severe pain after groin hernia repair : Five-year prospective data

Article/chapterEnglish2019

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2019

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LIBRIS-ID:oai:lup.lub.lu.se:0938431a-48a4-47dc-8856-62f01e834e8d
https://lup.lub.lu.se/record/0938431a-48a4-47dc-8856-62f01e834e8dURI
https://doi.org/10.1097/MD.0000000000016600DOI

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Language:English
Summary in:English

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Severe persistent pain after groin hernia repair impairs quality-of-life. Prospective, consecutive cohort study including patients with pain-related impairment of physical and social life. Relevant surgical records were obtained, and examinations were by standardized clinical and neurophysiological tests. Patients demonstrating pain sensitivity to pressure algometry in the operated groin underwent re-surgery, while patients with neuropathic pain received pharmacotherapy. Questionnaires at baseline (Q0) and at the 5-year time point (Q5Y) were used in outcome analyses of pain intensity (numeric rating scale [NRS] 0-10) and pain-related effect on the activity-of-daily-living (Activities Assessment Scale [AAS]). Data are mean (95% CI).Analyses were made in 172/204 (84%) eligible patients. In 54/172 (31%) patients re-surgery (meshectomy/selective neurectomy) was performed, while the remaining 118/172 (69%) patients received pharmacotherapy. In the re-surgery group, activity-related, and average NRS-scores at Q0 were 6.6 (5.6-7.9) and 5.9 (5.6-5.9), respectively. Correspondingly, NRS-scores at Q5Y was 4.1 (3.3-5.1) and 3.1 (2.3-4.0; Q0 vs. Q5Y: P < .0005), respectively. Although both groups experienced a significant improvement in AAS-scores comparing Q0 vs. Q5Y (re-surgery group: 28% (4-43%; P < .0001); pharmacotherapy group: 5% (0-11%; P = .005)) the improvement was significantly larger in the re-surgery group (P = .02).This 5-year cohort study in patients with severe persistent pain after groin hernia repair signals that selection to re-surgery or pharmacotherapy, based on examination of pain sensitivity, is associated with significant improvement in outcome. Analyzing composite endpoints, combining pain and physical function, are novel in exploring interventional effects.ClinicalTrials.gov Identifier NCT03713047.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Sjukgymnastik hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Physiotherapy hsv//eng
chronic post-surgical pain
groin
hernia repair
longitudinal study
neuropathic pain
nociceptive pain
pathophysiology
patient-reported outcomes

Added entries (persons, corporate bodies, meetings, titles ...)

Ringsted, Thomas K.Copenhagen University Hospital (author)
Bischoff, Joakim M.Copenhagen University Hospital (author)
Petersen, Morten A.Bispebjerg Hospital (author)
Rosenberg, JacobHerlev Hospital (author)
Kehlet, HenrikCopenhagen University Hospital (author)
Werner, Mads U.Lund University,Lunds universitet,Tumörmikromiljö,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Tumor microenvironment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Copenhagen University Hospital(Swepub:lu)onk-mwe (author)
Copenhagen University HospitalBispebjerg Hospital (creator_code:org_t)

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In:Medicine98:330025-7974

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Physiotherapy

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