Assessment of Patient Functional Status after Surgery

International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery

“…More recently, several questionnaires and validated score systems have been presented, concluding that pain should be assessed at rest as well as during well-defined functions corresponding to daily life tasks, including questions about pain influencing sexual function like dysejaculation [26,31,43,58,61].…”

Prevention of chronic pain after surgery: new insights for future research and patient care

“…24 Given obvious differences in anatomical regions, degree of tissue injury, and underlying surgical disease, evidence points to the need for conducting assessments of persistent postoperative pain in a procedure-specific fashion. 25,26 Furthermore, mounting evidence suggests that various preoperative factors (e.g., preexisting pain, psychological/psychiatric comorbidities) are associated with a greater risk of persistent postsurgical pain. 14,27 In this context, a genetic disposition for being a high-risk pain responder and at risk for persistent pain is currently receiving much attention.…”

“…25,26 En outre, des données probantes de plus en plus nombreuses laissent penser que divers facteurs préopératoires (par ex., une douleur préexistante, des comorbidités psychologiques / psychiatriques) sont associés à un risque accru de douleur postchirurgicale persistante. 14,27 Dans un tel contexte, l'hypothèse qu'il existe une prédisposition génétique à courir un risque élevé de réagir à la douleur et un risque de souffrir de douleur persistante reçoit à l'heure actuelle beaucoup d'attention de la part de la communauté scientifique.…”

Laparoscopic versus open groin hernia repair: are we getting closer to specific clinical recommendations?

“…In this study, two high-volume centres were chosen (one in Copenhagen and one in Stuttgart), each performing either a well-established Lichtenstein repair or a laparoscopic transabdominal pre-peritoneal (TAPP) repair. The results with detailed assessment of neurophysiological function in the surgical area, characteristics and intensity H. Kehlet (&) Section for Surgical Pathophysiology, Rigshospitalet Copenhagen University, Copenhagen, Denmark e-mail: henrik.kehlet@rh.dk and social consequences [5] of the persistent pain showed, as with most of the other studies [1], that there was about 50% less risk of persistent pain after the laparoscopic repair, and with a lower intensity. The detailed neurophysiological assessments showed, for the Wrst time, less sign of nerve damage with the laparoscopic mesh repair with glue Wxation [7].…”

“…Although much data on chronic pain after laparoscopic versus an open mesh repair are available [1], the problem with most of these studies is that they have been designed primarily to assess the risk of a recurrence and with chronic pain as a secondary outcome and most often assessed sub-optimally and not in relation to speciWc daily activities or well-described characteristics and intensity [5]. Furthermore, although chronic post-herniorrhaphy pain has been considered mostly to be of neuropathic origin [6], the documentation for neuropathic versus chronic inXammatory pain has been extremely scarce [6].…”