[Postoperative pain in prosthetic inguinal hernioplasty. Predictive factors and effects on patient recovery]

Tension free hernioplasty under local anaesthesia in day care basis is now the gold standard for inguinal hernia surgery, but a severe postoperative pain may affect convalescence and return to work, so minimizing economic benefits of day hospital.

To evaluate the incidence and predisposing factors of severe postoperative pain the authors examined 100 patients (96 men and 4 women, min. age 16 yrs, max 91 yrs, median age 53 yrs) operated from January 1999 to January 2000; in all cases a tension free hernioplasty under local anesthesia was performed.

Good results were obtained in 83% of patients for intraoperative comfort, in 91% for postoperative pain, in 86% for immediate postoperative walking and in 93% for walking in the first week. Postoperative pain (first 24 hours) was strictly correlated to intraoperative pain, while a difficult postoperative walking was predictive for a difficult walking in the first week.

Tension free hernioplasty allows a good functional recovery to daily activities since the first postoperative week; with an even more accurate patients selection and aggressive postoperative analgesia in pain risk patients better results will be achievable.