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Incidence of opioid use and early postoperative pain intensity after primary unilateral inguinal hernia repair at a single-center specialty hospital

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Abstract

Purpose

This research examined opioid use, pain intensity, and pain management after primary unilateral inguinal hernia repair (PUIHR) at a single-center specialty hospital.

Methods

After research, ethics board approval, and informed consent, pain scores (0–10 numerical rating scale [NRS]) were obtained from survey-based questionnaires administered at the pre- and 3-day postoperative timepoints. Descriptive results are presented as frequency, mean, standard deviation, range, median, and interquartile ranges, as appropriate. Significance tests were conducted to compare participants who did and did not receive opioids after surgery. p-value <0.05 is considered statistically significant. As the standard of care, participants received nonopioid multimodal analgesia (acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs)) and opioids, when necessary.

Results

A total of 414 and 331 participants completed the pre- and 3-day postoperative questionnaires, respectively. Out of the 414 participants, 38 (9.2%) received opioids during the postoperative stay. There was no significant difference between pain frequency or mean preoperative NRS pain intensity scores of those who did and did not receive opioids. Mean NRS pain intensity scores on day 3 after surgery were significantly higher for participants who received opioids (3.15±2.08) than those who did not (2.19±1.95), p=0.005.

Conclusion

Most participants did not receive opioids after PUIHR and had lower mean postoperative NRS pain intensity scores compared to those who did, most likely reflecting the need for opioids among the latter. Opioids were discontinued by day 3 for all participants who received them. Therefore, for most patients undergoing PUIHR, effective pain control can be achieved with nonopioid multimodal analgesia in the early postoperative period.

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Acknowledgements

We would like to thank Ms. Natalie Chow for her contributions and help. The authors would also like to acknowledge the contributions of Dr. Robert Bendavid, who had passed away before the publication of this paper.

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Authors and Affiliations

  1. Department of Surgery, Shouldice Hospital, ON, Canada

    Marguerite Mainprize, Ayse Yilbas & Fernando A. C. Spencer Netto

  2. UZIK Consulting Inc. Toronto, ON, Canada

    Anton Svendrovski

  3. Department of Psychology, York University, ON, Canada

    Joel Katz

Authors
  1. Marguerite Mainprize
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  2. Ayse Yilbas
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  3. Fernando A. C. Spencer Netto
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  4. Anton Svendrovski
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  5. Joel Katz
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Contributions

Joel Katz and Marguerite Mainprize contributed to the study conception and design with additional contributions from Ayse Yilbas and Fernando Spencer. Material preparation and data collection was performed by Marguerite Mainprize. Anton Svendrovski completed data analysis. The first draft of the manuscript was written by Marguerite Mainprize and all authors commented on subsequent versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Marguerite Mainprize.

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This study was a part of a larger project that was approved by the York University Research Ethics Board (e2019-189) and complies with institutional/national ethical standards. The larger ongoing study was preregistered at clinicaltrials.gov (NCT03986060).

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We obtained informed consent from all participants to collect and use their data.

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Mainprize, M., Yilbas, A., Spencer Netto, F.A.C. et al. Incidence of opioid use and early postoperative pain intensity after primary unilateral inguinal hernia repair at a single-center specialty hospital. Langenbecks Arch Surg 408, 366 (2023). https://doi.org/10.1007/s00423-023-03111-z

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