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Early pain after laparoscopic inguinal hernia repair. A qualitative systematic review

M A Tolver1, J Rosenberg, T Bisgaard

  • 1Department of Surgery, Køge Hospital, University of Copenhagen, Denmark. mette.astrup@gmail.com

Acta Anaesthesiologica Scandinavica
|January 21, 2012
PubMed

Insights

Early post-operative pain after laparoscopic groin hernia repair is most severe on the first day and dominated by deep abdominal pain. Younger patients and those with high pre-operative pain sensitivity experience more intense pain.

Area of Science:

  • Laparoscopic surgery
  • Pain management
  • Hernia repair

Background:

  • Early post-operative pain following laparoscopic groin hernia repair exhibits unique patterns and patient-specific predictors.
  • Understanding this pain is crucial for improving patient recovery after transabdominal pre-peritoneal repair (TAPP) and total extraperitoneal repair (TEP).

Purpose of the Study:

  • To characterize early post-operative pain (first week) after TAPP and TEP.
  • To identify patient-related predictors associated with early pain intensity.

Main Methods:

  • A qualitative systematic review was performed.
  • Searched major databases (PubMed, Embase, CINAHL, Cochrane) for relevant studies.
  • Included 71 studies encompassing 14,023 patients.

Main Results:

  • Pain is most severe on post-operative day 0 (13-58 mm VAS) and decreases by day 3.
  • No significant difference in pain intensity or duration between TEP and TAPP.
  • Deep abdominal pain predominates over superficial and referred shoulder pain after TAPP.
  • Younger age and high pre-operative heat pain sensitivity predict early pain.
  • Early pain intensity is a risk factor for chronic pain.

Conclusions:

  • Early pain after TAPP and TEP peaks on the first post-operative day, characterized by deep abdominal pain.
  • Younger patients report more intense early pain.
  • Pre-operative pain sensitivity predicts early post-operative pain intensity.
Abstract

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