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Chronic pain following a Lichtenstein inguinal hernia repair: a clinical and legal dilemma
Author(s) -
Paily Abhilash,
Thornton Michelle
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04980.x
Subject(s) - medicine , chronic pain , inguinal hernia , informed consent , hernia repair , hernia , recall , general surgery , physical therapy , surgery , alternative medicine , linguistics , philosophy , pathology
Background: Chronic pain following a Lichtenstein inguinal hernia is frequent and raises major concerns regarding informed consent recall Objective: To assess the frequency of chronic pain and associated factors following inguinal hernia repair in a district general hospital. To assess patient recall of the consent process as it pertains to chronic pain. Methods: A random sample (170/293 patients) of those who underwent a Lichtenstein inguinal hernia repair between 2002 and 2004 were retrospectively assessed for the frequency, intensity and other co‐factors of chronic pain. They were also questioned about their recollection of the consent process and information given regarding chronic pain. Results: 50 percent of patients reported chronic pain at a median follow‐up of 62 months with 30% reporting a significant impact on daily activities. Younger age, the absence of a lump at presentation, pre‐operative pain and elective repair were the only factors significantly shown to increase the likelihood of post‐operative pain. Patients with post‐operative pain were significantly more likely to report that they had not been informed of the possibility of chronic pain pre‐operatively or at the time of consent. Twenty percent of these patients stated that they would not have undergone the operation if they had been informed of the possibility of chronic pain. Conclusion: Chronic pain is frequent and debilitating. Documentation of chronic pain as a possible outcome at the time of consent should be mandatory as patient recall is poor.