Abstract
Poor acute pain control and inflammation are important risk factors for Persistent Postsurgical Pain (PPSP). The aim of the study is to investigate, in the context of a prospective cohort of patients undergoing hernia repair, potential risk factors for PPSP. Data about BMI, anxious-depressive disorders, neutrophil-tolymphocyte ratio (NLR), proinflammatory medical comorbidities were collected. An analysis for correlation between comorbidities and PPSP was performed in those patients experiencing chronic pain at 3 months after surgery. Tramadol resulted less effective in pain at movement in patients with a proinflammatory status. Preoperative hypertension and NLR > 4 were correlated with PPSP intensity. Regional anesthesia was significantly protective on PPSP when associated with ketorolac. Patients with pain at 1 month were significantly more prone to develop PPSP at 3 months. NSAIDs or weak opioids are equally effective on acute pain and on PPSP development after IHR, but Ketorolac has better profile in patients with inflammatory background or undergoing regional anesthesia. Drug choice should be based on their potential side effects, patient's profile (comorbidities, preoperative inflammation, and hypertension), and type of anesthesia. Close monitoring is necessary to early detect pain conditions more prone to progress to a chronic syndrome.
| Original language | English |
|---|---|
| Article number | 5830347 |
| Journal | Mediators of Inflammation |
| Volume | 2016 |
| DOIs | |
| Publication status | Published - 2016 |
Fingerprint
ASJC Scopus subject areas
- Immunology
- Cell Biology
Cite this
Effect of preoperative inflammatory status and comorbidities on pain resolution and persistent postsurgical pain after inguinal hernia repair. / Bugada, Dario; Lavand'Homme, Patricia; Ambrosoli, Andrea Luigi; Cappelleri, Gianluca; Saccani Jotti, Gloria Mr; Meschi, Tiziana; Fanelli, Guido; Allegri, Massimo.
In: Mediators of Inflammation, Vol. 2016, 5830347, 2016.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of preoperative inflammatory status and comorbidities on pain resolution and persistent postsurgical pain after inguinal hernia repair
AU - Bugada, Dario
AU - Lavand'Homme, Patricia
AU - Ambrosoli, Andrea Luigi
AU - Cappelleri, Gianluca
AU - Saccani Jotti, Gloria Mr
AU - Meschi, Tiziana
AU - Fanelli, Guido
AU - Allegri, Massimo
PY - 2016
Y1 - 2016
N2 - Poor acute pain control and inflammation are important risk factors for Persistent Postsurgical Pain (PPSP). The aim of the study is to investigate, in the context of a prospective cohort of patients undergoing hernia repair, potential risk factors for PPSP. Data about BMI, anxious-depressive disorders, neutrophil-tolymphocyte ratio (NLR), proinflammatory medical comorbidities were collected. An analysis for correlation between comorbidities and PPSP was performed in those patients experiencing chronic pain at 3 months after surgery. Tramadol resulted less effective in pain at movement in patients with a proinflammatory status. Preoperative hypertension and NLR > 4 were correlated with PPSP intensity. Regional anesthesia was significantly protective on PPSP when associated with ketorolac. Patients with pain at 1 month were significantly more prone to develop PPSP at 3 months. NSAIDs or weak opioids are equally effective on acute pain and on PPSP development after IHR, but Ketorolac has better profile in patients with inflammatory background or undergoing regional anesthesia. Drug choice should be based on their potential side effects, patient's profile (comorbidities, preoperative inflammation, and hypertension), and type of anesthesia. Close monitoring is necessary to early detect pain conditions more prone to progress to a chronic syndrome.
AB - Poor acute pain control and inflammation are important risk factors for Persistent Postsurgical Pain (PPSP). The aim of the study is to investigate, in the context of a prospective cohort of patients undergoing hernia repair, potential risk factors for PPSP. Data about BMI, anxious-depressive disorders, neutrophil-tolymphocyte ratio (NLR), proinflammatory medical comorbidities were collected. An analysis for correlation between comorbidities and PPSP was performed in those patients experiencing chronic pain at 3 months after surgery. Tramadol resulted less effective in pain at movement in patients with a proinflammatory status. Preoperative hypertension and NLR > 4 were correlated with PPSP intensity. Regional anesthesia was significantly protective on PPSP when associated with ketorolac. Patients with pain at 1 month were significantly more prone to develop PPSP at 3 months. NSAIDs or weak opioids are equally effective on acute pain and on PPSP development after IHR, but Ketorolac has better profile in patients with inflammatory background or undergoing regional anesthesia. Drug choice should be based on their potential side effects, patient's profile (comorbidities, preoperative inflammation, and hypertension), and type of anesthesia. Close monitoring is necessary to early detect pain conditions more prone to progress to a chronic syndrome.
UR - http://www.scopus.com/inward/record.url?scp=84962339040&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84962339040&partnerID=8YFLogxK
U2 - 10.1155/2016/5830347
DO - 10.1155/2016/5830347
M3 - Article
AN - SCOPUS:84962339040
VL - 2016
JO - Mediators of Inflammation
JF - Mediators of Inflammation
SN - 0962-9351
M1 - 5830347
ER -