Trigger-point Blockade in Persistent Pain After Laparoscopical Groin Hernia Repair

Trigger-point Blockade in Persistent Pain After Laparoscopically Assisted Groin Hernia Repair

Groin hernia repair is a common procedure performed in approximately 2,000 patients per one million inhabitants. Severe chronic pain following groin hernia repair is seen in 2-5% of the patients indicating that a large number of patients each year suffer from debilitating reduction in health-related quality of life.

This study examines the effect of ultra-sound guided blocks with local anesthesia in the groin in regard to pain relief and sleep quality.

The hypothesis of the study is that a block will confer significant pain relief to patients with severe chronic pain following laparoscopical groin hernia repair.

This placebo-controlled, randomized, double-blind, cross-over study in subjects with severe pain after laparoscopically assisted groin hernia repair, examines the effect of an ultra-sound guided local anesthetic block of a trigger-point, situated near the spermatic cord at the superficial inguinal ring.

Inclusion Criteria:

• Patients with persistent pain (< 6 mo) after laparoscopical groin hernia repair
• Patients with maximal pain area 3 cm or less from the superficial inguinal ring
• Patients living in the Capital Region of Denmark (Region Hovedstaden) or the Region of Zealand (Region Sjælland)

Exclusion Criteria:

• Known allergy to bupivacaine or other local anesthetics of amide-type
• Declared incapable of making his/hers own affairs
• Does not comprehend Danish in writing or speech
• Cognitive impairment to a degree influencing the testing reliability
• Known recurrence of the inguinal hernia
• Other surgical procedures performed in the groin or on the external genitals
• Neuropathy affecting the groin region caused by other conditions, e.g. post-stroke, multiple sclerosis, herniated intervertebral disc
• Abuse of alcohol or drugs
• Unable to cooperate with the sensory examinations