Logistic Analysis Of Risk Factor Of Chronic Pain After Inguinal Herniorrhaphy

Objective To investigate the incidence of chronic pain after inguinal hernia repair and its related risk factors,and provide theoretical reference to clinical prevention and treatment of chronic pain after inguinal hernia repair.Methods A retrospective analysis of clinical data of 1327 cases of patients from the People's Hospital of Xinjiang Uygur Autonomous Region from January 2011 to December 2015,which received inguinal hernia surgery,and to analysis the risk factors of chronic pain.Results There were 102cases(7.68%)of chronic pain after inguinal hernia in 1327 patients,including mild pain were 70 cases(5.27%),moderate pain were 23 cases(1.73%)and severe pain 9 cases(0.68%).Univariate analysis showed that:the age(18~40 years)(?~2=3.471,P=0.021),gender(female)(?2=17.241,P<0.001),smoking>20/d(?~2=3.618,P=0.019),history of cough(?~2=3.618,P=0.019),history of constipation(?~2=5.964,P=0.012),hernia size(>3.0cm)(?~2=6.243,P=0.010)(?~2=3.879,P=0.039),degree of preoperative pain(?~2=8.879,P<0.001),patch type(?~2=3.789,P=0.043)were correlated with postoperative chronic pain,andstatistical significance(P<0.05).Multivariate analysis showed that:age(18~40years)(OR=3.77,95%CI:1.52~6.42,P<0.001);Gender(female)(OR=3.21,95%CI:1.04~6.56,P=0.043);Smoking(>20/d)(OR=2.99,95%CI:1.22~5.10,P=0.035);Hernia size(>3.0cm)(OR=4.18,95%CI:1.97~7.15,P<0.001);Patch(Weight type)(OR=4.81,95%CI:1.44~7.18,P<0.001);Nerve stretch/injury(OR=10.76,95%CI:3.23~37.42,P<0.001);Incision infection(OR=2.26,95%CI:1.55~4.89,P=0.032)were the risk factor for chronic pain(OR>1);and the laparoscopic surgery(OR=0.53,95%CI:0.36~0.87,P=0.030)was the protective factor of chronic pain(OR<1).Conclusion Chronic pain after inguinal hernia repair is related with nerve traction and injury,smoking,preoperative pain degree,hernia size,surgical type,age(18~40 years old),gender(female),patch material and wound infection.Strengthening preoperative pain management and psychological counseling,and the surgery should be fine operation,avoiding blunt dissection and protection of nerve,and postoperative incision management are to reduce the ratio of pain and lessen severity of pains after operation for inguinal hernias.