Search Results (3)

Background and Objectives: In this study, we aimed to evaluate pain intensity in patients after pilonidal disease surgeries of varying extent using pressure algometry and the visual analog scale and to explore potential correlations between these methods. Materials and Methods: A total of 78 adult patients with symptomatic pilonidal cysts were enrolled in this study. The patients were divided into two groups based on the type of surgery assigned to each patient at the pre-hospital consultation: pit-picking surgery (n = 39) and radical excision (n = 39). The pain levels at the surgical site were assessed and compared using the visual analog scale (VAS) and pressure algometry the morning before surgery and the day after the operation. Results: There was no statistically significant difference (p > 0.05) in VAS measurement results between surgical groups when comparing pain intensity experienced by patients before, during, and after surgery. Notably, specific pressure algometry variables (pressure pain tolerance left 2.05 ± 1.46 compared to 1.42 ± 0.73 kg/cm², p = 0.02; maximum pressure pain tolerance left 2.91 ± 1.33 compared to 2.32 ± 1.14 kg/cm², p = 0.04; maximum pressure pain tolerance center 2.51 ± 1.07 compared to 1.91 ± 0.91 kg/cm², p = 0.01; interval of pressure pain tolerance center 0.98 ± 0.62 compared to 0.59 ± 0.39 kg/cm², p = 0.00) on the first postoperative day were significantly lower in the “pit-picking” group compared to the excision group. Furthermore, no statistically significant correlation was found between VAS and pressure algometry measurements either before surgery or on the first postoperative day. Conclusions: In the early postoperative period following pilonidal disease surgery of varying extents, pain measured with the VAS does not differ. In contrast, the pressure algometry method showed greater pain in the minimally invasive surgery cohort on the first postoperative day. However, further larger studies are needed to compare these pain assessment methods in reporting pain intensity experienced during patient movement. Full article

Background and Objectives: Quality of life (QoL) and chronic pain are important outcomes following hernia surgery. The long-term effects of Transcutaneous Electric Nerve Stimulation (TENS) on postoperative recovery are not well known. In this trial we investigated the role of TENS on QoL and on the incidence of chronic pain following inguinal hernia repair with mesh. Materials and Methods: A total of 80 male patients with elective primary unilateral hernia Lichtenstein repair were randomly allocated to receive TENS or a placebo-TENS procedure. The TENS group received conventional TENS twice a day on the first and second postoperative days. The intensity was set at 0–0.5 mA in the placebo-TENS group. General and hernia-specific QoL, as well as the incidence of chronic pain were assessed using SF-36v2 and the Carolinas comfort scale. Results: Less sensation of mesh was reported by the TENS group patients one week after surgery. At this time point, the mean sensation score was 6.07 ± 8.88 in the TENS group and 14.08 ± 16.67 in the placebo-TENS group (p = 0.029). Although at two days and one week postoperatively, TENS group patients tended to have less pain, less movement restrictions and better overall hernia-specific QoL, the differences were not statistically significant. At 6 months postoperatively, no incidence of chronic pain was found in either the placebo-TENS or TENS group. Conclusions: Conventional TENS applied in the early postoperative period following inguinal hernia repair with mesh was found to reduce mesh-related foreign body sensation one week after surgery. Promising results were also found for other QoL domains. Full article

Background and Objective. Timely assessment and prevention of risk factors for the main perioperative complications in elderly patients provide an opportunity to avoid them, decrease mortality, and diminish costs associated with longer hospital stay. The aim of this study was to estimate perioperative factors that could potentially predict the length of stay and to estimate their predictive value using a comprehensive geriatric assessment among elderly patients.
Material and Methods. The study population comprised 99 surgical patients aged 65 and more. The patients were followed up until discharge. Study data analysis included questionnaires, anthropometric measurements before surgery, assessment and interviews after surgery, and case histories. Univariate and multivariate logistic regression analysis was performed.
Results. Malnutrition was detected in 53.5% of the patients. Postoperative cognitive disorder was documented in 18.2% of elderly patients. The mean length of hospital stay was 10.1 days (SD, 9.14). Multivariate logistic regression analysis revealed that the best predictors for longer hospital stay in elderly patients were malnutrition (OR, 4.2; 95% CI, 1.5–11.8; P=0.007) together with postoperative cognitive impairment (OR, 9.2; 95% CI, 1.0–83.3; P=0.048). The total predictive value of the model was 70.5%.
Conclusions. Malnutrition and a postoperative cognitive disorder were independent risk factors for longer hospital stay, while depression, cognitive impairment, functional dependence, and poor physical status were not independently associated with longer hospital stay. A comprehensive geriatric assessment can help assess the risk factors for longer treatment and predict the length of hospital stay, thus enabling the planning of optimal healthcare management of elderly patients. Full article