The total number of patients who had ASA I-II scores and who had undergone a one-sided inguinal hernia repair under spinal anesthesia in elective conditions with at least three or more months of recovery time months was 619. Of these 264 patients, 203 with absence of pain (score of the severest pain over the past week and now was 0) were classified as the Non-Pain group and 61 patients with inguinal pain (score of the severest pain over the past week or now was 1 or more) were classified as the Pain group. The incidence of chronic pain after inguinal hernia surgery was 23.48% (n = 61) in our study. The pain was localized at and near the surgical incision and radiated into the scrotum in 17.73% (n = 36) of the male patients having chronic pain. While chronic pain developed in 60 out of 239 patients who had pain prior to the surgery. The presence of pain prior to the surgery was evaluated as an effective factor for the chronic groin pain. Neuropathic pain was detected with the DN-4 questionnaire in 6 (2.95%) out of 203 patients who stated that they had no pain during the physical examination and the week prior to the exam. The frequency of chronic pain after inguinal hernia repair was found 23.48% in our study. This is the same rate as previously reported. Quality of life of these patients was affected. We believe that there is an urgent need for prospective randomized studies with the aim of determining a standardized methodology towards preventive measures after determining the risk factors of chronic pain developed in the post inguinal hernia repair period.

Chronic postsurgical pain (CPSP) is an important clinic problem. It is assessed that prevalence of chronic pain extends to 30% but it is contended that there are various risk factors. We aimed to evaluate the prevalence of chronic pain after hysterectomy, risk factors of chronicity, neuropathic features of pain, and sensorial alterations at surgery area.Between years 2012 and 2015, 16 to 65 ages old patients that electively undergone total abdominal hysterectomy bilateral salpingo-oophorectomy and passed minimum 3 months after surgery were included to study. Visual analog scale (VAS) and Douleur Neuropathique 4-questionnaire (DN-4) surveys were used to evaluate pain symptoms, algometry device was used for evaluating abdominal pressure threshold and Von Frey Filament was used for sensorial alterations.Ninety-three of 165 eligible patients were included to study. As the groups were compared by demographic data, no difference was obtained (P > 0.05). There was no difference between groups regarding patient and surgery attributes (P > 0.05). Most frequently performed incision type was Pfannenstiel. Neuropathic symptoms were observed in 90 patients (96.8%). Sensorial alterations as hypoesthesia and hyperesthesia were detected around abdominal scar in 18 patients (19.4%) with pinprick test.Neuropathic symptoms should not be ignored in studies evaluating CPSP and a standard methodology should be designed for studies in this topic.

It is known that, unilateral thoracic paravertebral block (TPVB) applications performed with general anesthesia provide satisfactory conditions for open cholecystectomy increase the quality of post-operative analgesia and patient comfort and decrease the frequency of post-operative nausea and vomiting. In this case report, the TPVB was presented which was performed for two patients with high risk of anesthesia who have been planned to undergo open cholecystectomy.

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