4.4 Article

Incidence of opioid use and early postoperative pain intensity after primary unilateral inguinal hernia repair at a single-center specialty hospital

Journal

LANGENBECKS ARCHIVES OF SURGERY
Volume 408, Issue 1, Pages -

Publisher

SPRINGER
DOI: 10.1007/s00423-023-03111-z

Keywords

Opioid-sparing; Multimodal analgesia; Hernia; NSAIDs; Pain intensity; Surgery

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The study examined opioid use, pain intensity, and pain management following primary unilateral inguinal hernia repair (PUIHR) at a specialty hospital. Most participants did not require opioids for pain control post-surgery, and had lower mean NRS pain intensity scores compared to those who did. Opioids were discontinued by day 3 for all participants who received them, demonstrating effective pain control with nonopioid multimodal analgesia for most patients undergoing PUIHR.
Purpose This research examined opioid use, pain intensity, and pain management after primary unilateral inguinal hernia repair (PUIHR) at a single-center specialty hospital. Methods After research, ethics board approval, and informed consent, pain scores (0-10 numerical rating scale [NRS]) were obtained from survey-based questionnaires administered at the pre- and 3-day postoperative timepoints. Descriptive results are presented as frequency, mean, standard deviation, range, median, and interquartile ranges, as appropriate. Significance tests were conducted to compare participants who did and did not receive opioids after surgery. p-value <0.05 is considered statistically significant. As the standard of care, participants received nonopioid multimodal analgesia (acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs)) and opioids, when necessary. Results A total of 414 and 331 participants completed the pre- and 3-day postoperative questionnaires, respectively. Out of the 414 participants, 38 (9.2%) received opioids during the postoperative stay. There was no significant difference between pain frequency or mean preoperative NRS pain intensity scores of those who did and did not receive opioids. Mean NRS pain intensity scores on day 3 after surgery were significantly higher for participants who received opioids (3.15 +/- 2.08) than those who did not (2.19 +/- 1.95), p=0.005. Conclusion Most participants did not receive opioids after PUIHR and had lower mean postoperative NRS pain intensity scores compared to those who did, most likely reflecting the need for opioids among the latter. Opioids were discontinued by day 3 for all participants who received them. Therefore, for most patients undergoing PUIHR, effective pain control can be achieved with nonopioid multimodal analgesia in the early postoperative period.

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