INGUINAL HERNIA REPAIR: UNDERSTANDING CHRONIC POSTOPERATIVE PAIN

Abstract Introduction Persistent pain following inguinal hernia repair is a significant healthcare problem. Sleep disorders, chronic analgesic use, and preoperative inguinal pain are associated with increased pain sensitivity. Aim To assess the rate of chronic postoperative inguinal pain (CPIP) following inguinal hernia repair in patients with preoperative pain, chronic analgesic use, and the role of sleep disturbances. Methods Inguinal pain, chronic analgesic use, and sleep disorders in patients undergoing inguinal hernioplasty at our center between August and November 2022 were evaluated. Pain was assessed preoperatively and postoperatively and during follow-up using a VRS-4 and the IPQ questionnaire (sf-IPQ) in 72 patients. RESULTS It is evident that 48% of patients with preoperative pain do not experience improvement in pain after hernioplasty (p <0.05), similarly, patients with chronic analgesic intake continue to have CPIP in 46% (p = 0.01) compared to patients without preoperative inguinal pain and no analgesic intake. Preoperative sleep problems are related to the development of CPIP 12 months after surgery (OR 1.25 [95% CI: 1.11–2.01], p = 0.001). Conclusion At one-year follow-up, a 4.8% incidence of CPIP is recorded, of which 73.3% are potentially related to surgery, and 26.7% may be due to persistent preoperative pain. Women and patients who have taken sick leave due to this reason are at a higher risk of CPIP. Similarly, sleep disorders may increase the risk of CPIP and contribute to the maintenance of postsurgical pain.