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March 1997

A Prospective, Randomized Study of Open vs Laparoscopic Inguinal Hernia Repair: An Assessment of Postoperative Pain

Author Affiliations

From the Departments of Surgery, Veterans Affairs Medical Center, Allen Park, Mich (Drs Kozol, Lange, Kosir, and Tennenberg, and Mss Beleski and Mason); and Detroit Receiving Hospital (Dr Wilson and Ms Kubinec), Detroit, Mich.

Arch Surg. 1997;132(3):292-295. doi:10.1001/archsurg.1997.01430270078015

Objective:  To compare postoperative pain after laparoscopic hernia repair and conventional open hernia repair.

Design:  Prospective, randomized study.

Setting:  Veterans Affairs Medical Center.

Patients:  Sixty-two patients scheduled for elective inguinal hernia repair.

Interventions:  Patients were randomized in the operating room to have a laparoscopic hernia repair (30 patients) or a conventional open hernia repair (32 patients). All operations were performed while the patient was under general anesthesia to avoid anesthesia as a confounding variable.

Measures:  Postoperative pain following laparoscopic hernia repair and open hernia repair were compared using the McGill Pain Score, the McGill Visual Analogue Pain Scale score, and the number of acetaminophen with30-mg codeine sulfate (Tylenol 3) tablets needed for pain during the first and second 24-hour periods postoperatively. All of the patients were interviewed and the postoperative pain was evaluated by a special study nurse (P.M.L.) who was blinded to the repair technique.

Results:  At 24 hours, the patients with laparoscopic hernia repair had 26% less pain by the McGill Pain Score (P=.02) and 31% less pain by the McGill Visual Analogue Scale (P=.006) than those who underwent an open hernia repair. At 48 hours the patients who underwent laparoscopic hernia repair had 28% less pain by the McGill Pain Score (P=.03), 42% less pain by the McGill Visual Analogue Scale (P=.002), and used 42% fewer analgesic tablets (P=.004).

Conclusion:  atients with a laparoscopic hernia repair had significantly less pain postoperatively than those with standard open hernia repairs.Arch Surg. 1997;132:292-295

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