Impact of preoperative anxiety on chronic postoperative pain after inguinal hernia repair

This study aimed to investigate whether preoperative anxiety levels influence the incidence and severity of chronic postoperative pain in patients undergoing inguinal hernia repair.

A prospective observational study was conducted in 75 adult patients scheduled for elective inguinal hernia repair under general anesthesia. Preoperative anxiety was assessed using the State-Trait Anxiety Inventory (STAI). Pain intensity and characteristics were evaluated with the Numeric Rating Scale (NRS) at 24 h, 1 month, 3 months, and 6 months postoperatively. Chronic postoperative pain was defined as pain persisting for ≥ 3 months. Statistical analyses included Spearman correlation and logistic regression to identify predictors of chronic pain. The primary outcome was the incidence of chronic postoperative pain (CPSP), defined as NRS ≥ 1 at ≥ 3 months. Effect sizes are reported with 95% confidence intervals.

Of 75 enrolled patients, 64 completed the 6-month follow-up. Chronic postoperative pain was reported in 46.9% at 3 months and 39.1% at 6 months, with 25% experiencing moderate-to-severe pain (NRS ≥ 4) at 6 months. Persistent pain at 6 months was predominantly neuropathic in nature. Higher preoperative STAI-State and STAI-Trait scores were significantly correlated with pain intensity at 1, 3, and 6 months (p < 0.001). Multivariate logistic regression identified the STAI-State score as an independent predictor of chronic pain, with each 1-point increase raising the odds by 40% (OR 1.40, 95% CI 1.20-1.64).

Preoperative anxiety was associated with chronic postoperative pain after inguinal hernia repair. These findings highlight an association and underscore the need for larger multicenter studies with longer follow-up.

Not applicable.