.: ORİJİNAL ARAŞTIRMA
Risk Factors of Chronic Postoperative Pain After Inguinal Hernia Repair and the Relationship Between Preoperative Depression-Anxiety: Observational Study
İnguinal Herni Onarımı Sonrası Kronik Postoperatif Ağrının Risk Faktörleri ve Preoperatif Depresyon-Anksiyete İlişkisi: Gözlemsel Çalışma
Turkiye Klinikleri J Med Sci. 2024;44(4):149-57
doi: 10.5336/medsci.2024-102812
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: To determine the incidence and risk factors associated with chronic postoperative pain after inguinal hernia repair and to observe the relationship between preoperative depression/anxiety and chronic postoperative pain. Material and Methods: Between June 2021 and December 2022, two hundred and sixty patients who underwent inguinal hernia repair were enrolled in the study. Preoperative chronic pain and chronic postoperative pain were assessed with visual analogue scale, and the patients' results were recorded in the third and sixth months. Depression and anxiety assessments were made using the Beck Depression and Beck Anxiety Inventory before the operation. Preoperative, intraoperative, and postoperative details were recorded and the relationship with chronic postoperative pain was statistically analysed. Results: Pain persisted in 22.3% of the patients at the postoperative 3rd month and 12.3% of the patients at the 6th month. Preoperative pain was present in 56.53% of the patients, and chronic pain developed in 39.4%. A statistically significant relationship was found between preoperative chronic pain, postoperative analgesic use, duration of pain, female gender, reoperation, postoperative complication, and chronic postoperative pain (p<0.001). Chronic postoperative pain developed in 21 of 24 patients who underwent recurrent operations. The pain was in neuropathic character in 53.4% of the patients. A significant correlation was observed between preoperative anxiety/depression and chronic pain (p<0.001). Conclusion: Preoperative pain, the severity of postoperative acute pain, and reoperation should be questioned preoperatively, and adequate pain palliation should be provided to prevent chronic postoperative pain. In addition, the psychological state significantly affects the development of chronic postoperative pain.
Keywords: Hernia; inguinal; postoperative pain; depression; anxiety
Objective: To determine the incidence and risk factors associated with chronic postoperative pain after inguinal hernia repair and to observe the relationship between preoperative depression/anxiety and chronic postoperative pain. Material and Methods: Between June 2021 and December 2022, two hundred and sixty patients who underwent inguinal hernia repair were enrolled in the study. Preoperative chronic pain and chronic postoperative pain were assessed with visual analogue scale, and the patients' results were recorded in the third and sixth months. Depression and anxiety assessments were made using the Beck Depression and Beck Anxiety Inventory before the operation. Preoperative, intraoperative, and postoperative details were recorded and the relationship with chronic postoperative pain was statistically analysed. Results: Pain persisted in 22.3% of the patients at the postoperative 3rd month and 12.3% of the patients at the 6th month. Preoperative pain was present in 56.53% of the patients, and chronic pain developed in 39.4%. A statistically significant relationship was found between preoperative chronic pain, postoperative analgesic use, duration of pain, female gender, reoperation, postoperative complication, and chronic postoperative pain (p<0.001). Chronic postoperative pain developed in 21 of 24 patients who underwent recurrent operations. The pain was in neuropathic character in 53.4% of the patients. A significant correlation was observed between preoperative anxiety/depression and chronic pain (p<0.001). Conclusion: Preoperative pain, the severity of postoperative acute pain, and reoperation should be questioned preoperatively, and adequate pain palliation should be provided to prevent chronic postoperative pain. In addition, the psychological state significantly affects the development of chronic postoperative pain.
Keywords: Hernia; inguinal; postoperative pain; depression; anxiety
ÖZET
Amaç: Amaç, inguinal herni onarımı sonrası postoperatif kronik ağrı ile ilişkili insidans ve risk faktörlerini belirlemek ve preoperatif depresyon/anksiyete ile postoperatif kronik ağrı arasındaki ilişkiyi incelemekti. Gereç ve Yöntemler: Haziran 2021-Aralık 2022 tarihleri arasında inguinal herni onarımı yapılan 260 hasta çalışmaya alındı. Preoperatif kronik ağrı ve postoperatif kronik ağrı görsel analog skala skoru değerlendirildi ve hastaların operasyon sonrası 3 ve 6. aylardaki sonuçları kaydedildi. Ameliyat öncesi depresyon ve anksiyete değerlendirmeleri Beck Depresyon Envanteri ve Beck Anksiyete Envanteri kullanılarak yapıldı. Ameliyat öncesi, ameliyat sırası ve ameliyat sonrası detaylar kaydedildi ve kronik postoperatif ağrı ile ilişkisi istatistiksel olarak analiz edildi. Bulgular: Postoperatif 3. Ayda hastaların %22,3'ünde, 6. ayda ise hastaların %12,3'ünde ağrı devam etti. Hastaların %56,53'ünde preoperatif ağrı mevcuttu ve bu hastaların %39,4'ünde kronik ağrı gelişti. Preoperatif kronik ağrı, postoperatif analjezik kullanımı, ağrı süresi, kadın cinsiyet, reoperasyon, postoperatif komplikasyon ve postoperatif kronik ağrı arasında istatistiksel olarak anlamlı bir ilişki bulundu (p<0,001). Rekürren operasyon geçiren 24 hastanın 21'inde postoperatif kronik ağrı gelişti. Hastaların %53,4'ünde ağrı nöropatik karakterdeydi. Ameliyat öncesi anksiyete/depresyon ile kronik ağrı arasında anlamlı bir ilişki gözlendi (p<0,001). Sonuç: Preoperatif ağrı, postoperatif akut ağrının şiddeti ve reoperasyon preoperatif dönemde sorgulanmalı ve postoperatif kronik ağrıyı önlemek için yeterli ağrı palyasyonu sağlanmalıdır. Ek olarak, preoperatif psikolojik durum postoperatif kronik ağrı gelişiminde önemli bir etkiye sahiptir.
Anahtar Kelimeler: Herni; inguinal; postoperatif ağrı; depresyon; anksiyete
Amaç: Amaç, inguinal herni onarımı sonrası postoperatif kronik ağrı ile ilişkili insidans ve risk faktörlerini belirlemek ve preoperatif depresyon/anksiyete ile postoperatif kronik ağrı arasındaki ilişkiyi incelemekti. Gereç ve Yöntemler: Haziran 2021-Aralık 2022 tarihleri arasında inguinal herni onarımı yapılan 260 hasta çalışmaya alındı. Preoperatif kronik ağrı ve postoperatif kronik ağrı görsel analog skala skoru değerlendirildi ve hastaların operasyon sonrası 3 ve 6. aylardaki sonuçları kaydedildi. Ameliyat öncesi depresyon ve anksiyete değerlendirmeleri Beck Depresyon Envanteri ve Beck Anksiyete Envanteri kullanılarak yapıldı. Ameliyat öncesi, ameliyat sırası ve ameliyat sonrası detaylar kaydedildi ve kronik postoperatif ağrı ile ilişkisi istatistiksel olarak analiz edildi. Bulgular: Postoperatif 3. Ayda hastaların %22,3'ünde, 6. ayda ise hastaların %12,3'ünde ağrı devam etti. Hastaların %56,53'ünde preoperatif ağrı mevcuttu ve bu hastaların %39,4'ünde kronik ağrı gelişti. Preoperatif kronik ağrı, postoperatif analjezik kullanımı, ağrı süresi, kadın cinsiyet, reoperasyon, postoperatif komplikasyon ve postoperatif kronik ağrı arasında istatistiksel olarak anlamlı bir ilişki bulundu (p<0,001). Rekürren operasyon geçiren 24 hastanın 21'inde postoperatif kronik ağrı gelişti. Hastaların %53,4'ünde ağrı nöropatik karakterdeydi. Ameliyat öncesi anksiyete/depresyon ile kronik ağrı arasında anlamlı bir ilişki gözlendi (p<0,001). Sonuç: Preoperatif ağrı, postoperatif akut ağrının şiddeti ve reoperasyon preoperatif dönemde sorgulanmalı ve postoperatif kronik ağrıyı önlemek için yeterli ağrı palyasyonu sağlanmalıdır. Ek olarak, preoperatif psikolojik durum postoperatif kronik ağrı gelişiminde önemli bir etkiye sahiptir.
Anahtar Kelimeler: Herni; inguinal; postoperatif ağrı; depresyon; anksiyete
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