Management of Groin Herniorrhaphy-Related Chronic Postsurgical Pain: General Surgeons’ Understanding, Attitudes, and Experiences

Abstract

Aim: Groin herniorrhaphy is a common surgical procedure worldwide. Groin herniorrhaphy-related chronic postsurgical pain (GHCPSP) has a negative effect on quality of life. This survey evaluated general surgeons’ knowledge, attitudes, and experiences with GHCPSP. 
 Methods: A survey on GHCPSP was designed by two experienced general surgeons and a pain physician and reviewed by an experienced hernia surgeon. The survey included four questions to assess demographic characteristics of the respondents; four questions related to understanding of pain characteristics of GHCPSP and the effectiveness of pain treatments for GHCPSP; five questions about attitudes towards management of early postoperative pain and GHCPSP; five questions related to experience of surgical techniques for groin herniorrhaphy, consultation rates to pain and psychiatry clinics for multidisciplinary management of GHCPSP, and working collaboration with a pain clinic. The survey was emailed to all members of the Turkish Surgical Society.
 Results: The study included 259 respondents. The majority (248/95.8%) of respondents prescribed non-opiod medications for early postoperative pain control. A validated scale or questionnaire was used to assess GHCPSP by 20% of the respondents. 42% of the respondents favored paracetamol and/or NSAIDs for GHCPSP, and 42.9% favored multimodal agents for GHCPSP. The average consultation rates of respondents to pain and psychiatry clinics for GHCPSP was 30% and 1%, respectively.
 Conclusions: General surgeons have sufficient understanding of early herniorrhaphy-related pain but poor understanding of evaluating pain severity in CPSP and its management, suggesting a multidisciplinary approach to GHCPSP should be promulgated to general surgeons.