The effect of peri-operative pain neuroscience education on pain and recovery in adult patients receiving laparoscopic inguinal hernia repair.

To optimize the efficacy of analgesia for patients receiving laparoscopic inguinal hernia repair, peri-operative pain neuroscience education (PNE) as a pain-specific cognitive therapy was incorporated into multi-modal analgesia. A randomized controlled trial was conducted to compare conventional analgesia (group CA) and the addition of pain neuroscience education into it (group PNE) in patients receiving laparoscopic inguinal hernia repair. Characteristics of peri-operative pain was evaluated with Douleur Neuropathique 4 questionnaire (DN-4), central sensitization inventory (CSI), pain catastrophizing scale (PCS) post-operatively and pressure pain threshold. Post-operative quality of recovery was measured with EuroQol five dimensions questionnaire (EQ-5D-5L). The incidence of chronic post-operative pain was also recorded. A total of 184 patients consented to participate in this study and finished follow-up. Compared with those receiving conventional analgesia (group CA, N = 91), patients in group PNE (N = 93) reported reduced incidence of moderate-to-severe pain and less dosages of opioid during hospitalization (p < 0.05). Catastrophing, sensitization related to pain were reduced in group PNE (p < 0.05). Quality of recovery was improved till 1 month after surgery (p < 0.05). The addition of pain neuroscience education improved analgesic effect and quality of recovery for patients undergoing laparoscopic inguinal hernia repair. It also helped reduce sensitization and catastrophic of acute surgical pain. This psychologically-oriented analgesic approach merits future research and application for these patients.