Postoperative education and pain in patients with inguinal hernia

This paper reports a study to investigate whether education can reduce postoperative pain in patients operated on for inguinal hernia.

Operation for inguinal hernia is a frequent, elective procedure. Studies indicate that 20% of patients operated on for this condition still have moderate to severe pain on the sixth postoperative day. They also show a connection between postoperative pain and time to return to work, inconvenience relating to recreation and work and development of chronic pain.

The design was a randomized, clinically controlled, single-blinded study, carried out in 2002-2003. The intervention group received education on discharge from hospital, followed by a telephone interview on the second postoperative day. The control group was given the usual routine information. In a questionnaire, patients ranked their pain on a 100-mm Visual Analogue Scale on the first, third and seventh postoperative days.

The study included 234 consecutive patients. The baseline characteristics for the intervention and the control group were identical. Pain was analysed as the difference in Visual Analogue Scale scores immediately preoperatively and on the chosen days postoperatively. No difference was found for pain while resting, pain when moving on the first and third postoperative day and time to return to work. Statistically, there was a significant difference (P = 0.028) between the groups for pain when moving on the seventh postoperative day. The estimated mean difference was 7 mm (95% confidence interval 0.7-13.1 mm).

In patients operated on for inguinal hernia, postoperative education and a telephone interview have no effect on postoperative pain while resting and time to return to work. The effect on pain while moving was slight. There is no reason to change standard practice.