POSTOPERATIVE PAIN;

COMPARISON AFTER PRESERVATION AND ELECTIVE DIVISION OF ILIOINGUINAL NERVE IN INGUINAL HERNIOPLASTY

Abstract

Introduction: Postoperative inguinal pain is one of the most significant
complications following inguinal hernia repair. Routine ilioinguinal nerve excision has been
proposed as a means to avoid this complication. Objectives: To compare the postoperative pain
after preservation and elective division of ilioinguinal nerve during inguinal hernioplasty.
Methods: This was a Randomized Controlled Trial conducted at the department of general
surgery at KVSS Site Hospital for a period of 6 months from Jun 2011 to Nov 2011. 84 patients
who underwent mesh hernioplasty for unilateral inguinal hernia, were randomly assigned into two
groups (A and B), 42 in each group. Ilioinguinal nerve was preserved in group A patients, whereas
elective division was carried out in patients of group B. Mean postoperative pain scores were
recorded using numerical analogue scale on first and third postoperative day, and one month
after surgery. The SPSS version 16 was applied to the data. Results: Mean±SD age was
38.46±14.36 years. Seventy four (88.1%) patients were male whereas ten (11.9%) were female,
with male to female ratio being 7:1. Using the numerical analogue scale to detect pain severity on
postsurgical day 1 and 3, mean scores±SD in the nerve-preservation and nerve-excision groups
were 2.88±0.43 versus 2.04±0.39, and 1.95±0.39 versus 1.43±0.44, respectively (p<0.05). At 1
month after surgery, these scores were 1.73±0.62 versus 0.98±0.25, respectively (p<0.05).
Conclusions: Postoperative pain after inguinal hernioplasty significantly decreases in elective
division of ilioinguinal nerve as compared to nerve preservation.