Pain Clinical Trial
Official title:
The Effect of an Individualized Education Intervention Versus Usual Care on Pain Following Ambulatory Inguinal Hernia Repair
Pain after inguinal hernia repair surgery is common with more than 50% of patients reporting
moderate to severe acute pain following surgery. Analgesics are helpful in managing this
pain but patients can be reluctant to take analgesics due to potential adverse effects such
as nausea, vomiting or constipation. Patients may also be concerned about addiction to
analgesics or they may believe that experiencing moderate to severe pain after surgery is to
be expected.
The purpose of this study is to investigate the impact of an individualized education
program regarding pain and management of adverse effects on pain after inguinal hernia
repair surgery.
There is clear evidence that patients who have undergone ambulatory inguinal hernia (IHR)
repair have significant pain following surgery. Inguinal hernia repair has been identified
as one of the most painful ambulatory surgery procedures, with 98% of patients reporting
pain 24 hours following IHR surgery, and 54% of patients experiencing moderate to severe
pain in the first 72 hours. Despite experiencing continued pain, patients do not always take
the prescribed analgesics. Analgesics are helpful in managing post-operative pain but may
have adverse effects, including nausea, vomiting or constipation, which are often not
managed. Almost half of all patients who undergo ambulatory surgery experience these adverse
effects with 45% experiencing constipation and 46% experiencing nausea and/or vomiting in
the first 48 hours after surgery.
As well, patients may have concerns about addiction, or asking for help to manage their pain
and may believe that moderate to severe pain is to be expected, contributes to healing and
therefore is to be tolerated following surgery. Patients are expected to manage this pain
and adverse effects of analgesics at home. Minimal research has been found regarding
interventions to manage pain following ambulatory surgery, and none found specifically for
patients undergoing inguinal hernia repair.
The purpose of this trial is to investigate the impact of an individualized pre-operative
pain education intervention that includes a booklet with telephone support pre-operatively
and after discharge home versus usual care for patients having IHR surgery. The primary
outcome will be worst pain on movement in the past 24 hours and the secondary outcomes will
be pain related interference, pain quality, analgesic use and adverse effects, and patient
satisfaction and concerns with pain management.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Supportive Care
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