Department of Anesthesiology, Kasumigaura Medical Center Hospital, National Hospital Organization, Tsuchiura, Japan.
Department of Anesthesiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
J Perioper Pract. 2023 May;33(5):133-138. doi: 10.1177/17504589211054371. Epub 2022 Mar 24.
Laparoscopic inguinal hernia repair has significantly reduced the incidence of postoperative acute and chronic pain compared to open repair, but it remains problematic. This study's purpose was to retrospectively identify predictive factors of acute pain after laparoscopic inguinal hernia repair.
We reviewed the medical records of 193 patients. After excluding atypical cases and female patients, 156 patients were analysed. Factors affecting rescue analgesic requirements were investigated via multivariable logistic regression analysis. Independent variables included age, body mass index, analgesics used during surgery and surgical factors (unilateral/bilateral, primary/recurrent). The degree of postoperative pain and the hospital stay duration after surgery were also investigated.
Of the 156 patients, 40 (25.6%) required rescue analgesics. Patients under 60 years of age were about seven times more likely to need rescue analgesics than patients over 80 years of age. Primary surgery patients were about 5.5 times more likely to need rescue analgesics than recurrent surgery patients. The maximum verbal rating scale score was less than 3 in 89% of patients. All patients were discharged by two days postoperatively.
Laparoscopic inguinal hernia repair results in less postoperative acute pain. However, analgesia management should be considered prudently for younger patients and primary surgery patients.
与开放修复相比,腹腔镜腹股沟疝修补术显著降低了术后急性和慢性疼痛的发生率,但仍存在问题。本研究旨在回顾性确定腹腔镜腹股沟疝修补术后急性疼痛的预测因素。
我们回顾了 193 名患者的病历。排除非典型病例和女性患者后,对 156 名患者进行了分析。通过多变量逻辑回归分析研究了影响抢救性镇痛需求的因素。自变量包括年龄、体重指数、手术期间使用的镇痛药和手术因素(单侧/双侧、原发性/复发性)。还调查了术后疼痛程度和术后住院时间。
在 156 名患者中,有 40 名(25.6%)需要抢救性镇痛。60 岁以下的患者比 80 岁以上的患者需要抢救性镇痛的可能性大约高 7 倍。原发性手术患者比复发性手术患者需要抢救性镇痛的可能性大约高 5.5 倍。89%的患者的视觉模拟评分法(VAS)评分均小于 3。所有患者均在术后两天内出院。
腹腔镜腹股沟疝修补术后急性疼痛程度较轻。然而,对于年轻患者和原发性手术患者,应谨慎考虑镇痛管理。