title: Determinant factors of pain after ambulatory inguinal herniorrhaphy: a multi-variate analysis.
abstract: Pain is common after inguinal herniorrhaphy. The objective of our study was to evaluate the significance of various clinical factors on the level of post-operative pain after ambulatory inguinal herniorrhaphy. Between January, 1996 and December, 1998, 239 ambulatory inguinal hernia repair patients were recruited. Operative techniques included nylon darn (n = 152), modified Bassini repair (n = 56), and prolene mesh hernioplasty (n = 30). Linear analogue pain scores--ranging in value from 0 to 10--were assessed by telephone interviews on the first and third post-operative days. Uni-variate and multi-variate analyses were performed to identify the significant independent determinant factors affecting the severity of post-operative pain. Clinical factors studied were age, sex, operative technique, hernia anatomy and post-operative complication(s). By uni-variate analysis, patients of age < or = 50 years and indirect inguinal hernia were associated with a significantly higher pain score on the first postoperative day 1. On post-operative day 3, patients of age < or = 50 years, with an indirect inguinal hernia and modified Bassini repair reported a significantly higher pain score. Following inguinal herniorrhaphy, multiple regression analysis showed that age was the only independent predictive factor of pain score on post-operative days 1 and 3. In conclusion, post-operative pain was not affected by surgical technique, sex, hernia anatomy and post-operative morbidity. Only age had a significant influence on the post-operative pain score following ambulatory inguinal herniorrhaphy. Therefore, the age of a patient should be taken into consideration when prescribing post-operative analgesics.
authors.affiliation: Department of Surgery, University of Hong Kong Medical Centre, Tung Wah Hospital, Sheung Wan, Hong Kong, China.
authors.forename: H
authors.initials: H
authors.lastname: Lau
authors.forename: F
authors.initials: F
authors.lastname: Lee
mesh_terms: D000367:Age Factors; D000556:Ambulatory Surgical Procedures; D005260:Female; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis*; D011183:Postoperative Complications; D012737:Sex Factors; D018434:Sickness Impact Profile; D013536:Suture Techniques; D013997:Time Factors