Hernia : the journal of hernias and abdominal wall surgery
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There is little information available on recurrence rates following primary open inguinal hernia repair in women. Women are less prone to inguinal hernias than men; for the same reason, recurrences after hernia repair may also be lower so that the well-known advantage of using mesh could be lost on them. ⋯ The routine use of mesh for open indirect inguinal hernia repair in women may not be necessary.
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In groin hernia repair studies, chronic pain is a frequently used primary endpoint. However, its impact on daily life activities has been less investigated. Such an outcome is relevant for the patient and surgeon and cannot be extrapolated out of pain scores. The Pain Disability Index (PDI), a questionnaire wherein patients rate their impairment, could reveal the consequences of pain. The PDI was therefore introduced in a trial upon open mesh-based inguinal hernia repair. ⋯ The PDI is feasible in inguinal hernia repair and can be used as an adjuvant in pain measurement. It can identify patients still suffering postoperatively who might otherwise be missed. Furthermore, the PDI could serve as a predictor for chronic pain.
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Randomized Controlled Trial
The effect of supplemental 70% oxygen on postoperative nausea and vomiting in patients undergoing inguinal hernia surgery.
Postoperative nausea and vomiting (PONV) are among the leading side-effects after surgery performed under general anaesthesia. The role of oxygen as an important method for treatment of PONV was studied. The aim of this study was to compare intraoperative 30% oxygen with 70% oxygen for improvement of PONV in patients undergoing inguinal hernia surgery. ⋯ Supplemental oxygen effectively prevents postoperative nausea and vomiting after inguinal hernia surgery: the higher the arterial oxygen saturation, the less frequent PONV.
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Several tools for pain measurement including a Visual Analogue Scale (VAS) and a Verbal Rating Scale (VRS) are currently used in patients with chronic pain. The aim of the present study was to determine which of these two pain tests performs optimally in patients following groin hernia repair. ⋯ Because of lower scale failure rates and overlapping VAS scores per VRS category, the VRS should be favored over the VAS in future postherniorrhaphy pain assessment. If VAS is preferred, the presented cut-off points should be utilized.
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The incidence of chronic pain after Kugel herniorrhaphy is not well documented, since it was not used as a primary outcome measure in studies reporting on the Kugel technique. The aim of the present study was to report on the incidence and severity of chronic pain 1 year after Kugel herniorrhaphy and to identify the risk factors associated with the development of chronic pain. ⋯ The Kugel inguinal hernia repair is associated with a low rate of postoperative chronic pain. The minimally invasive preperitoneal approach of the Kugel technique probably causes less nerve damage and subsequent neuropathic pain. Chronic pain seems to be more common in young female patients with immediate postoperative pain.