Effect of Preoperative Inflammatory Status and Comorbidities on Pain Resolution and Persistent Postsurgical Pain after Inguinal Hernia Repair
Poor acute pain control and inflammation are important risk factors for Persistent Postsurgical Pain (PPSP). The aim of the study is to investigate, in the context of a prospective cohort of patients undergoing hernia repair, potential risk factors for PPSP. Data about BMI, anxious-depressive disord...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2016/5830347 |
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| author | Dario Bugada Patricia Lavand’homme Andrea Luigi Ambrosoli Gianluca Cappelleri Gloria MR Saccani Jotti Tiziana Meschi Guido Fanelli Massimo Allegri |
| author_facet | Dario Bugada Patricia Lavand’homme Andrea Luigi Ambrosoli Gianluca Cappelleri Gloria MR Saccani Jotti Tiziana Meschi Guido Fanelli Massimo Allegri |
| author_sort | Dario Bugada |
| collection | DOAJ |
| description | Poor acute pain control and inflammation are important risk factors for Persistent Postsurgical Pain (PPSP). The aim of the study is to investigate, in the context of a prospective cohort of patients undergoing hernia repair, potential risk factors for PPSP. Data about BMI, anxious-depressive disorders, neutrophil-tolymphocyte ratio (NLR), proinflammatory medical comorbidities were collected. An analysis for correlation between comorbidities and PPSP was performed in those patients experiencing chronic pain at 3 months after surgery. Tramadol resulted less effective in pain at movement in patients with a proinflammatory status. Preoperative hypertension and NLR > 4 were correlated with PPSP intensity. Regional anesthesia was significantly protective on PPSP when associated with ketorolac. Patients with pain at 1 month were significantly more prone to develop PPSP at 3 months. NSAIDs or weak opioids are equally effective on acute pain and on PPSP development after IHR, but Ketorolac has better profile in patients with inflammatory background or undergoing regional anesthesia. Drug choice should be based on their potential side effects, patient’s profile (comorbidities, preoperative inflammation, and hypertension), and type of anesthesia. Close monitoring is necessary to early detect pain conditions more prone to progress to a chronic syndrome. |
| format | Article |
| id | doaj-art-ae819f05d90845cda851087ce70556ca |
| institution | OA Journals |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-ae819f05d90845cda851087ce70556ca2025-08-20T02:23:08ZengWileyMediators of Inflammation0962-93511466-18612016-01-01201610.1155/2016/58303475830347Effect of Preoperative Inflammatory Status and Comorbidities on Pain Resolution and Persistent Postsurgical Pain after Inguinal Hernia RepairDario Bugada0Patricia Lavand’homme1Andrea Luigi Ambrosoli2Gianluca Cappelleri3Gloria MR Saccani Jotti4Tiziana Meschi5Guido Fanelli6Massimo Allegri7Department of Surgical Sciences, University of Parma, Via Gramsci 14, 43126 Parma, ItalyDepartment of Anesthesia and Perioperative Medicine, Catholic University of Louvain, St Luc Hospital, 10 Avenue Hippocrate, 1200 Brussels, BelgiumDay Surgery Unit, Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi, Polo Universitario, Viale Luigi Borri 57, 21100 Varese, ItalyDepartment of Anesthesia, Istituto Ortopedico G. Pini, Piazza Cardinale Andrea Ferrari 1, 20122 Milan, ItalyDepartment of Biomedical, Biotechnological & Translational Sciences (S.Bi.Bi.T), Faculty of Medicine, University of Parma, Via Gramsci 14, 43126 Parma, ItalyDepartment of Clinical and Experimental Medicine, University of Parma, Via Gramsci 14, 43126 Parma, ItalyDepartment of Surgical Sciences, University of Parma, Via Gramsci 14, 43126 Parma, ItalyDepartment of Surgical Sciences, University of Parma, Via Gramsci 14, 43126 Parma, ItalyPoor acute pain control and inflammation are important risk factors for Persistent Postsurgical Pain (PPSP). The aim of the study is to investigate, in the context of a prospective cohort of patients undergoing hernia repair, potential risk factors for PPSP. Data about BMI, anxious-depressive disorders, neutrophil-tolymphocyte ratio (NLR), proinflammatory medical comorbidities were collected. An analysis for correlation between comorbidities and PPSP was performed in those patients experiencing chronic pain at 3 months after surgery. Tramadol resulted less effective in pain at movement in patients with a proinflammatory status. Preoperative hypertension and NLR > 4 were correlated with PPSP intensity. Regional anesthesia was significantly protective on PPSP when associated with ketorolac. Patients with pain at 1 month were significantly more prone to develop PPSP at 3 months. NSAIDs or weak opioids are equally effective on acute pain and on PPSP development after IHR, but Ketorolac has better profile in patients with inflammatory background or undergoing regional anesthesia. Drug choice should be based on their potential side effects, patient’s profile (comorbidities, preoperative inflammation, and hypertension), and type of anesthesia. Close monitoring is necessary to early detect pain conditions more prone to progress to a chronic syndrome.http://dx.doi.org/10.1155/2016/5830347 |
| spellingShingle | Dario Bugada Patricia Lavand’homme Andrea Luigi Ambrosoli Gianluca Cappelleri Gloria MR Saccani Jotti Tiziana Meschi Guido Fanelli Massimo Allegri Effect of Preoperative Inflammatory Status and Comorbidities on Pain Resolution and Persistent Postsurgical Pain after Inguinal Hernia Repair Mediators of Inflammation |
| title | Effect of Preoperative Inflammatory Status and Comorbidities on Pain Resolution and Persistent Postsurgical Pain after Inguinal Hernia Repair |
| title_full | Effect of Preoperative Inflammatory Status and Comorbidities on Pain Resolution and Persistent Postsurgical Pain after Inguinal Hernia Repair |
| title_fullStr | Effect of Preoperative Inflammatory Status and Comorbidities on Pain Resolution and Persistent Postsurgical Pain after Inguinal Hernia Repair |
| title_full_unstemmed | Effect of Preoperative Inflammatory Status and Comorbidities on Pain Resolution and Persistent Postsurgical Pain after Inguinal Hernia Repair |
| title_short | Effect of Preoperative Inflammatory Status and Comorbidities on Pain Resolution and Persistent Postsurgical Pain after Inguinal Hernia Repair |
| title_sort | effect of preoperative inflammatory status and comorbidities on pain resolution and persistent postsurgical pain after inguinal hernia repair |
| url | http://dx.doi.org/10.1155/2016/5830347 |
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