![]() ![]() While the surgery generally is considered a minor procedure with limited tissue damage, it is carried out in a delicate territory with abundant nerves and blood vessels and is involved in complex musculoskeletal functions, essential for locomotor actions. Groin hernia repair qualifies for PPSP-research due to a high surgical volume. ![]() Other causes of the pain should be excluded, e.g., infection or continuing malignancy in cancer surgery. Examination of pain trajectories, mirroring the transition from acute to severe persistent post-surgical pain, has the potential of uncovering clinically relevant pathophysiological mechanisms. Pain trajectories in PPSP after groin hernia repair are heterogeneous but can be classified into meaningful groups. The PCA/logistic analyses indicated that neuropathic pain scores, composite pain scores, and pain-related functional assessments were explanatory variables for groups I and II. Data from groups IV (n=3) and V (n=9) were not included in the statistical analysis due to small sample size and data heterogeneity, respectively. In 95 patients, the AUC identified groups of post-surgical pain trajectories (p<0.0001): group I (n=48), acute high-intensity pain progressing to PPSP group II (n=28), delayed onset of PPSP group III (n=7), repeat-surgery gradually inducing PPSP. Significant PCA-components were further examined using multiple logistic regression models. Principal component analysis (PCA) was applied to the explanatory variables. Pain trajectories were normalized, and pre- and post-surgical segments were analyzed by a normalized area-under-the-curve (AUC) technique. Surgical records and quantitative sensory testing profiles were obtained. Patients completed graphs on pain trajectories and questionnaires on neuropathic pain, pain-related functional assessments, and psychometrics. Potential explanatory variables based on individual psychometric, sensory, and surgical profiles were analyzed. This study evaluated pain-trajectories in a consecutive cohort referred from groin hernia repair-surgeons to a tertiary PPSP-center. ![]() While the trajectory of PPSP is generally considered a continuation of the acute post-surgery pain, recent data suggest the condition may develop with a delayed onset. In the third most common surgical procedure in the U.K., groin hernia repair, including 85,000 surgeries, estimated 1,500–3,000 patients will annually develop severe PPSP. Severe persistent post-surgical pain (PPSP) remains a significant healthcare problem. ![]()
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