Analysis Of Factors Related To Chronic Pain After Tension-free Inguinal Hernia Repair

Objective:The aim is to investigate the incidence of chronic pain after tension-free inguinal hernia repair and to screen the risk factors related to chronic pain,in order to provide a theoretical reference for the clinical prevention and treatment of chronic pain after inguinal hernia repair and reduce the incidence of chronic pain.Methods:The clinical data of 571 patients who were diagnosed with inguinal hernia and tension-free inguinal hernia repair in the general surgery of Shanxi Provincial People’s Hospital from January 2018 to April 2019 were selected,and the selected cases were strictly selected.A total of 522 cases were selected.All patients met the inclusion and exclusion criteria,and the clinical data of all patients were analyzed retrospectively.Statistical analysis of the incidence of postoperative chronic pain,divided into chronic pain group and non-chronic pain group according to whether postoperative chronic pain occurred.Compare the general information of the two groups of patients,analyze and calculate the items with differences,and find out the risk factors of chronic pain after operation.SPSS 21.0 software was used to process the research data.Logistic regression was used to analyze the risk factors of chronic pain after tension-free repair of inguinal hernia.P < 0.05 was considered statistically significant.Results:Of all 522 patients,94 had postoperative chronic pain with an incidence of 18.08%.There were no significant differences in gender,diabetes,hypertension,coronary heart disease,chronic obstructive pulmonary disease,constipation,anesthesia,surgical methods,patch fixation,the location of the lesion,hernia type,Diameter of hernia ring mouth,operation time,hematoma and recurrence(P>0.05).There were statistical differences in Age(P=0.017),non-first operation(P=0.001),preoperative pain(P=0.001),chronic cough(P=0.005),prostatic hyperplasia(P=0.016),intraoperative nerve pulling or injury(P=0.022),postoperative acute pain(P=0.044),incision infection(P=0.01).Multivariate Logistic analysis showed that Preoperative pain(OR=2.074,P=0.004),non-first operation(OR=6.236,P=0.044),prostatic hyperplasia(OR=2.257,P=0.023),intraoperativenerve pulling or injury(OR=1.265,P=0.035),and incision infection(OR=9.467,P=0.016)were independent risk factors for chronic pain after tension-free inguinal hernia repair.Conclusions:The incidence of chronic pain after tension-free repair of inguinal hernia in this study was 18.08%.Multivariate analysis showed that preoperative pain,non-first surgery,benign prostatic hyperplasia,To pull or injure a nerve during surgery and incision infections caused chronic postoperative independent risk factors for pain.Therefore,clinical medical personnel should formulate targeted preventive measures for such risk factors,preoperative psychological counseling and the intervention of diseases with increased abdominal pressure,professional and careful operation during the operation,nerve protection,postoperative incision management and rational use of small dose of ketamine for postoperative analgesia are conducive to alleviating postoperative pain and reducing the incidence of chronic pain.