Investigating the safety and efficacy of nerve stimulation for management of groin pain after surgical herniorrhaphy: a systematic review and meta-analysis

Investigating the safety and efficacy of nerve stimulation for management of groin pain after surgical herniorrhaphy: a systematic review and meta-analysis

Purpose Chronic post-operative inguinal pain (CPIP) following inguinal hernia repair has been a major sequela affecting 4000–48000 patients annually. Optimal management of CPIP has been a challenge, and pharmacological management particularly with opioids has shown unsatisfactory results. The main o...

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Bibliographic Details
Published in:Hernia : the journal of hernias and abdominal wall surgery Vol. 27; no. 6; pp. 1363 - 1373
Main Authors: Shekouhi, R., Farz, F., Sohooli, M., Mohammadi, S., Abbasi, A., Razaghi, M., Fereydouni, M., Sohrabi, M., Seyed-Alagheband, S.-A., Darabi, M. H.
Format: Journal Article
Language:English
Published: Paris Springer Paris 01-12-2023
Springer Nature B.V
Subjects:
Abdominal Surgery
Acupuncture
Adult
Analgesics
Chronic Pain - surgery
Chronic Pain - therapy
Disease management
Female
Groin - surgery
Hernia
Hernia, Inguinal - surgery
Herniorrhaphy - adverse effects
Herniorrhaphy - methods
Humans
Male
Medicine
Medicine & Public Health
Meta-analysis
Middle Aged
Neuromodulation
Pain
Pain, Postoperative - surgery
Pain, Postoperative - therapy
Patients
Review
Statistical analysis
Surgical Mesh
Systematic review
Nerve stimulation
Groin pain
Neuromodulation
Inguinal hernia
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Summary:Purpose Chronic post-operative inguinal pain (CPIP) following inguinal hernia repair has been a major sequela affecting 4000–48000 patients annually. Optimal management of CPIP has been a challenge, and pharmacological management particularly with opioids has shown unsatisfactory results. The main objective of this systematic review is to investigate the safety and efficacy of neuromodulation as an alternative intervention for the management of post-operative inguinal pain. Methods A literature search was conducted by three reviewers to identify all relevant studies on the use of neuromodulatory interventions for treating post-operative inguinal pain. Data on study characteristics, neuromodulatory modalities, and patient’s clinical data such as pre/post-interventional pain scores and analgesic requirements were extracted and reported. Results A total of 389 patients with 357 (95.9%) males and 15 (4.1%) females were evaluated. The mean age of study participants was 47.9 ± 10.4 years. There were 187 (48.1%) and 202 (51.9%) patients allocated to the control and trial groups, respectively. The most common neuromodulation modality was TENS (4, 36.4%), followed by SCS (3, 27.3%), PNS (3, 27.3%), and acupuncture-assisted (2, 18.2%). The overall mean follow-up duration of the entire cohort was 3.8 months. The mean difference between pre-operative and post-operative VAS scores in the trial groups was 4.65 (95% Confidence Interval [CI], 2.97, 6.33), which was statistically significant ( P value < 0.05). Patient-reported outcome measures showed significant responsiveness toward their treatments. Conclusion Nerve stimulation, in its many forms, is a safe and feasible option for the management of post-operative inguinal pain.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Commentary-5
ObjectType-Review-4
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ISSN:1248-9204
1265-4906
1248-9204
DOI:10.1007/s10029-023-02861-5