CHRONIC POSTOPERATIVE PAIN FOLLOWING GROIN HERNIA REPAIR: A COMPARISON BETWEEN NERVE PRESERVATION AND NERVE EXCISION

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Abstract

Objective: The aim of the study was to compare the chronic postoperative pain following groin hernia repair with nerve
preservation and nerve excision.
Material And Methods: The study was Randomized controlled trial conducted from January 2011 to january 2013 (of
2 year duration) at Surgical Department Hayatabad Medical Complex, Peshawar. Total number of 176 patients, aged
between 18-70 years, having primary, unilateral inguinal hernia were enrolled from the Out Patients Department using
convenience sampling. Patients were alternately divided into Group A (ilieo-inguinal nerve preservation) and Group B
(ilieo-inguinal nerve excision). All patients underwent Lichtenstein tension free mesh hernioplasty. Chronic pain was
assessed at 1 and 3 months of follow up.
Results: There were two surgical groups, Group A: (88 patients), Group B: (88 patients). At one month interval, Group
A were having mild, moderate and severe pain in 32 (36.4%), 18 (20.5) and 8 (8.1%) patients respectively while Group
B patients were having mild 23 (26.1%), moderate 6 (6.8%) and severe 2 (2.3%) pain with a p-value of 0.001. Three
months follow-up revealed mild, moderate and severe pain in 21 (23.9%), 6 (6.8%) and 3 (3.4%) patients respectively
for Group A while Group B patients were having mild 8 (9.1%), moderate 0 (0%) and severe 1 (1.1%) pain with a highly
significant P-value 0.001.
Conclusion: To reduce the incidence of chronic post-operative pain of hernia surgery, it is necessary to have a thorough
knowledge of the groin anatomy to avoid injury or entrapment of the nerves by sutures or staples.
Key Words: Mesh repair, nerve excision, nerve preservation, visual analogue scale (VAS).

Authors: 
Irfan Ul Islam Nasir1
Muhammad Iftikhar1
Rashid Aslam2
Jamshed Alam2
Journal Issue: 

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