Cryoanalgesia:: Effect on postherniorrhaphy pain

被引:30
作者
Callesen, T
Bech, K
Thorup, J
Andersen, J
Nielsen, R
Roikjær, O
Kehlet, H
机构
[1] Copenhagen Univ Hosp, HS Hvidovre Hosp, Dept Anesthesiol, Hvidovre, Denmark
[2] Copenhagen Univ Hosp, HS Hvidovre Hosp, Dept Surg Gastroenterol, Hvidovre, Denmark
关键词
D O I
10.1097/00000539-199810000-00028
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Cryoanalgesia versus sham treatment was applied to the ilioinguinal and iliohypogastric nerves after mesh repair of an inguinal hernia under local anesthesia in 48 male patients in a prospective, randomized, and observer- and patient-blinded trial. Pain was scored daily during rest, while coughing, and during mobilization to the sitting position for 1 wk and weekly for 8 wk on a four-point verbal rank scale. Use of supplementary analgesics and sensory disturbances were recorded. Assessments were made for allodynia, hyperalgesia, and mechanical pain detection thresholds 8 wk postoperatively. Cumulative pain scores for the first postoperative week were equal in the two groups, as was the use of analgesics. Eight weeks postoperatively, three cases of hyperalgesia to pinprick were detected in the cryoanalgesia group, and 10 patients in the cryoanalgesia group versus 5 in the sham-treatment group reported disturbed sensibility. We conclude that cryoanalgesia of the iliohypogastrical and ilioinguinal nerve does not decrease postherniorrhaphy pain. Implications: Does freezing of sensory nerves in the groin reduce pain after hernia repair? Extreme cold (-60 degrees C) was applied in a double-blind, randomized study. No difference in pain scores was found. Sensory disturbances were seen in treatment and control patients. Freezing cannot be recommended for pain relief after hernia repair.
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页码:896 / 899
页数:4
相关论文
共 11 条
[1]   LOCAL-ANESTHESIA FOR INGUINAL-HERNIA REPAIR STEP-BY-STEP PROCEDURE [J].
AMID, PK ;
SHULMAN, AG ;
LICHTENSTEIN, IL .
ANNALS OF SURGERY, 1994, 220 (06) :735-737
[2]  
Amid PK, 1996, EUR J SURG, V162, P447
[3]   Postherniorrhaphy pain [J].
Callesen, T ;
Kehlet, H .
ANESTHESIOLOGY, 1997, 87 (05) :1219-1230
[4]   CRYOANALGESIA - THE APPLICATION OF LOW-TEMPERATURES TO NERVES TO PRODUCE ANESTHESIA OR ANALGESIA [J].
EVANS, PJD .
ANAESTHESIA, 1981, 36 (11) :1003-1013
[5]  
KATZ J, 1980, LANCET, P512
[6]   CRYOANALGESIA FOR PAIN AFTER HERNIORRHAPHY [J].
KHIROYA, RC ;
DAVENPORT, HT ;
JONES, JG .
ANAESTHESIA, 1986, 41 (01) :73-76
[7]   IMPROVED PAIN RELIEF AFTER THORACOTOMY - USE OF CRYOPROBE AND MORPHINE INFUSION [J].
ORR, IA ;
KEENAN, DJM ;
DUNDEE, JW .
BMJ-BRITISH MEDICAL JOURNAL, 1981, 283 (6297) :945-948
[8]   Analgesic and anti-inflammatory effects of lignocaine-prilocaine (EMLA) cream in human burn injury [J].
Pedersen, JL ;
Callesen, T ;
Moiniche, S ;
Kehlet, H .
BRITISH JOURNAL OF ANAESTHESIA, 1996, 76 (06) :806-810
[9]  
Racz G, 1992, PAIN DIGEST, V2, P43
[10]   POSTOPERATIVE ANALGESIA FOR DAY-CASE HERNIORRHAPHY PATIENTS - A COMPARISON OF CRYOANALGESIA, PARAVERTEBRAL BLOCKADE AND ORAL ANALGESIA [J].
WOOD, GJ ;
LLOYD, JW ;
BULLINGHAM, RES ;
BRITTON, BJ ;
FINCH, DRA .
ANAESTHESIA, 1981, 36 (06) :603-610