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Predictors of Acute Postsurgical Pain After Inguinal Hernioplasty

  • Patrícia R. Pinto
    Correspondence
    Address reprint requests to Patrícia R. Pinto, PhD, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga 4710-057, Portugal.
    Affiliations
    Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal

    Life and Health Sciences Research Institute (ICVS)/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
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  • Artur Vieira
    Affiliations
    Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal

    Life and Health Sciences Research Institute (ICVS)/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal

    Anesthesiology Department, Braga Hospital, Braga, Portugal
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  • Diamantino Pereira
    Affiliations
    Anesthesiology Department, Braga Hospital, Braga, Portugal
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  • Armando Almeida
    Affiliations
    Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal

    Life and Health Sciences Research Institute (ICVS)/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
    Search for articles by this author

      Highlights

      • Younger age was associated with higher levels of acute pain after inguinal hernioplasty.
      • Previous chronic pain was a significant predictor of pain intensity after inguinal hernioplasty.
      • Presurgical anxiety was predictive of acute pain after inguinal hernioplasty.
      • The rumination component of pain catastrophizing significantly predicted acute pain after surgery.
      • This study highlights modifiable intervention targets for interventions focused on pain prevention and management.

      Abstract

      Acute postsurgical pain (APSP) is a common and anticipated problem after surgery with detrimental consequences if not appropriately managed. This study examined the independent and joint contribution of presurgical demographic, clinical, and psychological variables as predictors of APSP intensity, evaluated using an 11-point numeric rating scale, after inguinal hernioplasty, one of the most performed surgeries worldwide. In a prospective observational cohort study, a consecutive sample of 135 men undergoing hernioplasty was assessed before and 48 hours after surgery. When adjusted for depression, helplessness, and magnification scores, a multiple hierarchical regression analysis revealed that younger age (β = −.247, P < .005), previous chronic pain (β = .175, P < .05), presurgical anxiety (β = .235, P < .05), and the rumination component of pain catastrophizing (β = .222, P < .05) were significant predictors of APSP intensity. The integrative predictive model found in this study revealed the simultaneous influence that demographic, clinical, and psychological factors have on APSP after inguinal hernioplasty. Therefore, these results improve knowledge on APSP predictors after inguinal hernioplasty and highlight potential modifiable intervention targets, such as anxiety and pain catastrophizing (rumination), for the design of interventions focused on APSP prevention and management. Hence, taken together, these findings lend support for the inclusion of presurgical screening and psychological interventions among surgical patients at risk for higher APSP intensity.

      Perspective

      This study found that, when adjusted for depression, helplessness, and magnification scores, the variables younger age, previous chronic pain, presurgical anxiety, and the rumination component of pain catastrophizing are significant predictors of APSP intensity after inguinal hernioplasty. These findings improve knowledge on APSP and highlight potential modifiable intervention targets for the design of interventions focused on APSP prevention and management.

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