Comparison of Frequency of Post-Operative Pain in Nerve Excision Vs Nerve Preservation During Inguinal Hernioplasty for Inguinal Hernia

Abstract

Objective: To compare the outcome in terms of post-operative pain in cases where ilio-inguinal nerve is sectioned electively with those where nerve is preserved during hernioplasty for primary inguinal hernia. Study Design: Randomized Controlled Trial. Settings: Surgical Units of Allied & DHQ hospital, Faisalabad Pakistan. Duration: 1 year from Jan 2017 to Dec 2017. Methodology: Approval from ethical review committee was obtained and patients from OPD based on the inclusion criteria were enrolled after informed consent. They were randomly divided into two groups. Patients in Group A had their ilio-inguinal nerve excised whereas it was preserved in patients in Group B. These procedures were performed by senior surgeons. Follow up was done by preserving patients’ telephone numbers in protocol proforma. Pain was assessed after 1 month of the procedure. Whole information was added on a Performa. Results: The study showed, mean age in Group A was  28.58+3.29 years and 33.8+8.35 years in Group B. 85% of patients(n=34)  in Group A were males and 15%(n=6) were females whereas 77.5%(n=31) in Group B were males and 22.5%(n=9) were females. Frequency of post-operative pain in both groups was calculated and it was found that 32.5% of the patients (n=13) in Group A and 57.5% (n=23) in Group B had pain. On the other hand, 67.5% of patients (n=27) in Group A and 42.5% (n=17) in Group B had no pain (p value =0.024). This demonstrates a clear difference between the two study groups. Conclusion: In the nutshell that the outcome in terms of frequency of post-operative pain is significantly better in cases where ilio-inguinal nerve is sectioned as compared with those where nerve is preserved during hernioplasty for inguinal hernia.