![]() While the surgery generally is considered a minor procedure with limited tissue damage, it is carried out in a delicate territory with abundant nerves and blood vessels and is involved in complex musculoskeletal functions, essential for locomotor actions. Groin hernia repair qualifies for PPSP-research due to a high surgical volume. Other causes of the pain should be excluded, e.g., infection or continuing malignancy in cancer surgery. Examination of pain trajectories, mirroring the transition from acute to severe persistent post-surgical pain, has the potential of uncovering clinically relevant pathophysiological mechanisms. ![]() Pain trajectories in PPSP after groin hernia repair are heterogeneous but can be classified into meaningful groups. The PCA/logistic analyses indicated that neuropathic pain scores, composite pain scores, and pain-related functional assessments were explanatory variables for groups I and II. Data from groups IV (n=3) and V (n=9) were not included in the statistical analysis due to small sample size and data heterogeneity, respectively. In 95 patients, the AUC identified groups of post-surgical pain trajectories (p<0.0001): group I (n=48), acute high-intensity pain progressing to PPSP group II (n=28), delayed onset of PPSP group III (n=7), repeat-surgery gradually inducing PPSP. Significant PCA-components were further examined using multiple logistic regression models. Principal component analysis (PCA) was applied to the explanatory variables. Pain trajectories were normalized, and pre- and post-surgical segments were analyzed by a normalized area-under-the-curve (AUC) technique. Surgical records and quantitative sensory testing profiles were obtained. Patients completed graphs on pain trajectories and questionnaires on neuropathic pain, pain-related functional assessments, and psychometrics. Potential explanatory variables based on individual psychometric, sensory, and surgical profiles were analyzed. ![]() This study evaluated pain-trajectories in a consecutive cohort referred from groin hernia repair-surgeons to a tertiary PPSP-center. ![]() While the trajectory of PPSP is generally considered a continuation of the acute post-surgery pain, recent data suggest the condition may develop with a delayed onset. In the third most common surgical procedure in the U.K., groin hernia repair, including 85,000 surgeries, estimated 1,500–3,000 patients will annually develop severe PPSP. Severe persistent post-surgical pain (PPSP) remains a significant healthcare problem. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |