A PROSPECTIVE, RANDOMIZED STUDY OF OPEN VS LAPAROSCOPIC INGUINAL-HERNIA REPAIR - AN ASSESSMENT OF POSTOPERATIVE PAIN

Objective: To compare postoperative pain after laparoscopic hernia rep air and conventional open hernia repair. Design: Prospective, randomiz ed study. Setting: Veterans Affairs Medical Center. Patients: Sixty-tw o patients scheduled for elective inguinal hernia repair. Intervention s: Patients were randomized in the operating room to have a laparoscop ic hernia repair (30 patients) or a conventional open hernia repair (3 2 patients). All operations were performed while the patient was under general anesthesia to avoid anesthesia as a confounding variable. Mea sures: Postoperative pain following laparoscopic hernia repair and ope n hernia repair were compared using the McGill Pain Score, the McGill Visual Analogue Pain Scale score, and the number of acetaminophen with 30-mg codeine sulfate (Tylenol 3) tablets needed for pain during the first and second 24-hour periods postoperatively. All of the patients were interviewed and the postoperative pain was evaluated by a special study nurse (P.M.L.) who was blinded to the repair technique. Results : At 24 hours, the patients with laparoscopic hernia repair had 26% le ss pain by the McGill Pain Score (P=.02) and 31% less pain by the McGi ll Visual Analogue Scale (P=.006) than those who underwent an open her nia repair. At 48 hours the patients who underwent laparoscopic hernia repair had 28% less pain by the McGill Pain Score (P=.03), 42% less p ain by the McGill Visual Analogue Scale (P=.002), and used 42% fewer a nalgesic tablets (P=.004). Conclusion: Patients with a laparoscopic he rnia repair had significantly less pain postoperatively than those wit h standard open hernia repairs.