Department of Surgery, Shouldice Hospital, ON, Canada.
UZIK Consulting Inc. Toronto, ON, Canada.
Langenbecks Arch Surg. 2023 Sep 19;408(1):366. doi: 10.1007/s00423-023-03111-z.
This research examined opioid use, pain intensity, and pain management after primary unilateral inguinal hernia repair (PUIHR) at a single-center specialty hospital.
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.
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.
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.
本研究在一家单中心专科医院调查了单侧腹股沟疝修补术（PUIHR）后阿片类药物的使用、疼痛强度和疼痛管理情况。
研究完成后，经伦理委员会批准并获得知情同意，通过基于问卷调查的方式，在术前和术后 3 天分别获得疼痛评分（0-10 数字评分量表[NRS]）。适当情况下，描述性结果以频率、平均值、标准差、范围、中位数和四分位距呈现。对术后接受和未接受阿片类药物的参与者进行了显著性检验。p 值<0.05 被认为具有统计学意义。作为标准治疗，参与者接受了非阿片类药物的多模式镇痛（对乙酰氨基酚和非甾体抗炎药[NSAIDs]）和阿片类药物（必要时）。
共有 414 名和 331 名参与者分别完成了术前和术后 3 天的问卷调查。在 414 名参与者中，有 38 名（9.2%）在术后住院期间接受了阿片类药物。接受和未接受阿片类药物的患者的疼痛频率或术前 NRS 疼痛强度评分平均值无显著差异。术后第 3 天，接受阿片类药物的患者的 NRS 疼痛强度评分平均值（3.15±2.08）显著高于未接受阿片类药物的患者（2.19±1.95），p=0.005。
大多数 PUIHR 患者术后未接受阿片类药物治疗，且术后 NRS 疼痛强度评分平均值低于接受阿片类药物治疗的患者，这可能反映了后者对阿片类药物的需求。所有接受阿片类药物的患者在第 3 天停用了阿片类药物。因此，对于大多数接受 PUIHR 的患者，在术后早期通过非阿片类药物多模式镇痛可以实现有效的疼痛控制。
