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An Assessment of Postoperative Pain

Robert Kozol, MD; Patricia M. Lange, PhD, RN; Mary Kosir, MD; Karen Beleski, RN; Kim Mason, CRNA; Steven Tennenberg, MD; Susan M. Kubinec; Robert F. Wilson, MD

Arch Surg. 1997;132(3):292-295.

Abstract
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 with

30-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

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.

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