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Risks for Pain-Neuropathic Pain: How Should We Handle the Nerves?

  • D. Kaemmer
  • R. Rosch
  • M. Stumpf
  • J. Otto
  • K. Junge
  • U. Klinge
  • V. Schumpelick

Abstract

In hernia surgery, interest has been focused more and more on pain, a problem that remained underestimated because only relatively few patients seemed to be affected. Chronic pain evolves in a high percentage after surgery with the need to mobilize or even compress nerves [1]; however, after groin hernia repair, symptoms vary to a high degree [2]. Pain character is mostly neuropathic, but due to overlapping distribution areas it is not clearly related to certain nerves [3]. The neuropathic pain character is accompanied by an inflammatory pain for some time after operation, which is understandable, especially when a mesh was used and foreign material remains in the body.

Keywords

Hernia Repair Chronic Groin Pain Lichtenstein Repair Ilioinguinal Nerve Genitofemoral Nerve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    H. Kehlet, T.S. Jensen, C.J. Woolf, Persistent postsurgical pain: risk factors and prevention. Lancet 367 (2006) 1618–1625CrossRefPubMedGoogle Scholar
  2. 2.
    A.S. Poobalan, J. Bruce, W.C. Smith, et al., A review of chronic pain after inguinal herniorrhaphy. Clin J Pain 19 (2003) 48–54CrossRefPubMedGoogle Scholar
  3. 3.
    T. Mikkelsen, M.U. Werner, B. Lassen, H. Kehlet, Pain and sensory dysfunction 6 to 12 months after inguinal herniotomy. Anesth Analg 99 (2004) 146–151CrossRefPubMedGoogle Scholar
  4. 4.
    E.K. Aasvang, B. Brandsborg, B. Christensen, et al., Neurophysiological characterization of postherniotomy pain. Pain 137 (2008) 173–181CrossRefPubMedGoogle Scholar
  5. 5.
    R. Rosch, K. Junge, M. Knops, et al., Analysis of collagen-interacting proteins in patients with incisional hernias. Langenbecks Arch Surg 387 (2003) 427–432PubMedGoogle Scholar
  6. 6.
    P. Hu, E.M. McLachlan, Selective reactions of cutaneous and muscle afferent neurons to peripheral nerve transection in rats. J Neurosci 23 (2003) 10559–10567PubMedGoogle Scholar
  7. 7.
    D.G. Kline, E.R. Hackett, G.D. Davis, M.B. Myers, Effect of mobilization on the blood supply and regeneration of injured nerves. J Surg Res 12 (1972) 254–266CrossRefPubMedGoogle Scholar
  8. 8.
    J. Haftek, Stretch injury of peripheral nerve. Acute effects of stretching on rabbit nerve. J Bone Joint Surg Br 52 (1970) 354–365PubMedGoogle Scholar
  9. 9.
    K. Ogata, M. Naito, Blood flow of peripheral nerve effects of dissection, stretching and compression. J Hand Surg [Br] 11 (1986) 10–14Google Scholar
  10. 10.
    F. Karakayali, M. Karatas, U. Ozcelik, et al., Influence of synthetic mesh on ilioinguinal nerve motor conduction and chronic groin pain after inguinal herniorrhaphy: a prospective randomized clinical study. Int Surg 92 (2007) 344–350PubMedGoogle Scholar
  11. 11.
    J. Lewin-Kowalik, W. Marcol, K. Kotulska et al., Prevention and management of painful neuroma. Neurol Med Chir (Tokyo) 46 (2006) 62–67CrossRefGoogle Scholar
  12. 12.
    J. Wu, D.T. Chiu, Painful neuromas: a review of treatment modalities. Ann Plast Surg 43 (1999) 661–667PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • D. Kaemmer
    • 1
  • R. Rosch
  • M. Stumpf
    • 1
  • J. Otto
    • 1
  • K. Junge
    • 2
  • U. Klinge
    • 3
  • V. Schumpelick
    • 1
  1. 1.Department of SurgeryRWTH Aachen University HospitalAachenGermany
  2. 2.Department of SurgeryTechnical University of AachenAachenGermany
  3. 3.Institute for Applied Medical Engineering Helmholtz Institute for Applied Medical TechnologyRWTH Aachen UniversityAachenGermany

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