Assessment and Prevention of Acute Post-herniotomy Pain

Randomized, Prospective Study of the Assessment, Prevention and Management of Acute Post-herniotomy Pain

The aim of the study is the assessment and management of Acute Post-herniotomy Pain using two different therapeutical protocols per os: ketorolac versus association of acetaminophene+tramadol.

Persistent post-herniotomy pain (PPP) affects everyday activities in 5-10% of patients. Even brief intervals of acute pain can induce long-term neuronal remodeling and sensitization, chronic pain and lasting psychological distress. Chronic pain may be caused by intense acute PPP, intraoperative nerve injury and/or ongoing inflammation or mesh response with subsequence damage to nerve structures. The aim of our study is to analyze analgesic efficacy, safety and prevention of persistent postsurgical pain of two different pharmacological strategies.

Inclusion Criteria:

• Males and females over 18 years, under 80 years, scheduled for elective herniotomy
• Classification American Society of Anesthesiologists (ASA) I: without systemic disease
• Classification ASA II or III (mild systemic disease or severe systemic disease that limits the activity without invalidity).
• Patients with hernia typ 2, 3a, 3b (classification NYHUS (1993))
• Signed informed consent

Exclusion Criteria:

• ASA III, IV
• Emergency surgery
• Recovery in intensive care unit after surgery
• habitual opioid consumption
• NSADs allergy
• cognitive or mental alterations
• coagulopathy
• piastrinemia < 100.000/mm3