Pain control following inguinal herniorrhaphy: current perspectives
Martin F Bjurstrom,1,* Andrea L Nicol,2,* Parviz K Amid,3 David C Chen3
1Department of Anesthesiology, UCLA, Los Angeles, CA, USA; 2Department of Anesthesiology, University of Kansas, Kansas City, KS, USA; 3Department of Surgery, Lichtenstein Amid Hernia Clinic at UCLA, UCLA, Los Angeles, CA, USA
*These authors contributed equally to this work
Abstract: Inguinal hernia repair is one of the most common surgeries performed worldwide. With the success of modern hernia repair techniques, recurrence rates have significantly declined, with a lower incidence than the development of chronic postherniorrhaphy inguinal pain (CPIP). The avoidance of CPIP is arguably the most important clinical outcome and has the greatest impact on patient satisfaction, health care utilization, societal cost, and quality of life. The etiology of CPIP is multifactorial, with overlapping neuropathic and nociceptive components contributing to this complex syndrome. Treatment is often challenging, and no definitive treatment algorithm exists. Multidisciplinary management of this complex problem improves outcomes, as treatment must be individualized. Current medical, pharmacologic, interventional, and surgical management strategies are reviewed.
Keywords: inguinodynia, chronic postherniorrhaphy inguinal pain, inguinal hernia
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