Page 56 - herina surgery and possible lawsuits

• Postoperative pain assessed by various researchers using various tools. Commonly
used tools are Verbal rating scale (VRS), Visual analogue scale (VAS), Numerical
Rating Scale (NRS), McGill Pam Questionnaire and SF-36 Questionnaire.
• McGill Pain Questionnaire (McPQ), SF-36 Questionnaire, Duration-Intensity-

Behavior Scale(DIBS), Carohnas Comfort Scale (CCS) Pain Disability Index (PDI)
and Wisconsin Brief Pam Questionnaire (WBPQ are used to assess the quality of life

with different dimensions of physical functioning, pain, general health, vitality, social
functioning, emotional and mental health. These are multidimensional questionnaires
assessing sensory, affective and psychosocial aspects ofpain.[109,110]

• In contrast, the Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), and
Numerical Rating Scale (NRS) are simple unidimensional tests that only rate sensory
components of pain and omit affective and psychosocial pain aspects. All three pain­

rating scales are valid, reliable and appropriate for use in clinical practice, although
the Visual Analogue Scale has more practical difficulties than the Verbal Rating
Scale.

• For general purposes the Visual Analogue Scale has good sensitivity and generates
data that can be statistically analyzed for audit purposes. Patients who seek a sensitive
pain-rating scale would probably choose this one. For simplicity patients prefer the

Verbal Rating Scale, but it lacks sensitivity and the data it produces can be
misunderstood. [Ill]
The ideal pam assessment tool should be determined by type of pain and the setting in which
it is measured. Researchers commonly rely on unidimensional systems, as multidimensional

questionnaires are generally considered too long and too complicated[l 10].
Unidimensional scales have routinely been employed in the evaluation of post herniorrhaphy
groin pain syndromes [110]

1. Verbal ratine scale (VRS) • it is graded with a 4-point verbal rating as - no pain, mild,
moderate and severe. They defined as below -
Mild pain - occasional pain and did not require analgesics.
Moderate pain - affecting patients’ daily activities, required analgesics occasionally

Severe pain - restrained patients from daily activities and required routine analgesics.
2. Visual analome scale (VAS): it is a 10-cm horizontal line labeled ‘no pain’ at one end

(with 0 points) and ‘worst pain imaginable’ (with 100 points) at the other end. The
patients are asked to mark on this line where the severity of pain is shown.[l 10,112]

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