Effect of postoperative analgesia on acute and persistent postherniotomy pain: a randomized study

Journal of Clinical Anesthesia
Dario BugadaSIMPAR group

Abstract

The study objective is to identify differences in postoperative pain management according to different analgesic treatments, targeting 2 main pathways involved in pain perception. The design is a randomized, parallel groups, open-label study. The setting is in an operating room, postoperative recovery area, and surgical ward. There are 200 patients undergoing open inguinal hernia repair (IHR) with tension-free technique (mesh repair). The intervention is a randomization to receive ketorolac (group K) or tramadol (group T) for 3 days after surgery. The measurements are differences in analgesic efficacy (numeric rating scale [NRS]) in the postoperative (up to 5 days) period, chronic pain incidence (1 and 3 months), side effects, and complications. We found no differences in analgesic efficacy (NRS value ≥4 in the first 96 hours: 26% in group K vs 32% in group T, P = .43); the proportion of patients with NRS ≥4 was similar in both groups, and the time trajectories were not significantly different (P for interaction = .24). Side effects were higher (12% vs 6%) in the tramadol group, although not significantly (P = .14), with a case of bleeding in the ketorolac group and higher incidence of constipation in tramadol group. One patien...Continue Reading

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