AN ASSESSMENT OF PAIN AND RETURN TO NORMAL ACTIVITY - LAPAROSCOPIC HERNIORRHAPHY VS OPEN TENSION-FREE LICHTENSTEIN REPAIR

Background: Laparoscopic herniorrhaphy is controversial and deserves c ritical evaluation. Methods: In a randomized prospective study transab dominal preperitoneal laparoscopic herniorrhaphy (n = 24) was compared in patients to the tension-free Lichtenstein repair (n = 29) utilizin g validated and reliable pain and activity assessment tools. The Sickn ess Impact Profile (SIP) was used to compare preoperative normal activ ity to postoperative activity. A Pain-O-Meter (visual analogue scale p lus affective and sensory pain descriptors) assessed intensity of pain . The total pain assessment score and SIP were com pared across time ( postoperative day 1-42). Analgesic medication was used as a covariate. Results: The total pain score was less for laparoscopic herniorrhaphy but this did not reach statistical significance. Similarly, the SIP s howed modest improvement for laparoscopic herniorrhaphy. No difference s between groups were noted for morphine equivalents of administered a nalgesics or length of hospitalization. Conclusion: Further investigat ion of laparoscopic herniorrhaphy is warranted.