Page 53 - herina surgery and possible lawsuits

Post herniorrhaphy groin pain
J

The surgical injury can lead to chronic pain is well reviewed using a systematic collection of

data, the estimated mcidences of chronic pam after leg amputation about 60%, thoracotomy
about 50%, breast surgery about 30%, cholecystectomy 10-20%, and inguinal herniorrhaphy
about 10%. Predictive risk factors for chrome postoperative pain mclude preoperative pain,

repeat surgery, psychological vulnerability, workers compensation, surgical approach with
risk of nerve damage, moderate or severe intensity of acute postoperative pain, radiation
therapy, neurotoxic chemotherapy, depression and anxiety. [102, 103]

Post hemioplasty mild pam lasting for a few days is common following mesh inguinal hernia
repair. However, moderate to severe pam persisting more than 3 months after inguinal
surgery should be considered pathological.

Chronic pain definitions:
• The International Association for the Study of Pam (IASP) defines pain as an
"unpleasant sensory and emotional experience associated with actual or potential

tissue damage or described in terms of such damage". This definition declares that the
pam having a physiological basis as well as a very real psychological or subjective

component. [12]
• National Library Medicine MeSH term has defined pain as “An unpleasant sensation
induced by noxious stimuli which are detected by nerve endings of nociceptive

neurons”.[ll]
• International Consensus Conference on hernia m Rome had consensually defined

chrome groin pam according to the IASP definition which was based on non surgical
chronic pam. The following definition for chrome post herniorrhaphy neuropathic
pam: “a pain arising as a direct consequence of a nerve lesion or a disease affecting
the somatosensory system, m patients who did not have groin, pain before then

original hernia operation, or, if they did, the post-operative pam differs from the pre­
operative pain”. A present, clinical diagnosis of neuropathic pam is not well
defined. [104]

Transition between acute and chronic pain is defined by most authors m terms of time.
• The IASP provides one of the most referenced definitions of chrome pam. Chrome
pam is that which persists beyond the normal time frame for healing, usually taken to

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