Evaluation of the surgical factor in postoperative pain control

BACKGROUND: Postoperative pain control has been studied extensively, including many perioperative pain control procedures. Unfortunately, the impact of the surgical technique was not objectively studied. AIM: The aim of this study is to evaluate if the type of surgical dissection needed for extensive abdominal wall dissection actually has an effect in the reduction of postoperative pain or not. MATERIALS AND METHODS: Forty adult patients, 19 males and 21 females, were randomly divided into two groups with each group containing 20 patients having different varieties of anterior abdominal wall ventral hernia. Patients in group I had their hernias and abdominal wall flaps dissected by only sharp dissection using scalpel. Patients in group II had their hernias and abdominal wall flaps dissected using mainly blunt dissection assisted by sharp dissection where blunt dissection could not do the job. All the patients had general anesthesia. No preemptive analgesia was used. Nalbufen was used as the only postoperative pain killer and the total amount used of it was treated as the indicator for the intensity of postoperative pain. RESULTS: The results of the present study showed that the total amount of Nalbufen used for the control of postoperative pain is significantly less in group I throughout the postoperative follow-up period. CONCLUSION: This study concludes that use of sharp dissection in cases of extensive abdominal wall dissection is statistically better than other methods of dissection in terms of postoperative pain control.