PROSPECT provides clinicians with supporting arguments for and against the use of various interventions in postoperative pain based on published evidence and expert opinion. Clinicians must make judgements based upon the clinical circumstances and local regulations. At all times, local prescribing information for the drugs referred to must be consulted.
GoRs are assigned according to the overall LoE on which the recommendations are based, which is determined by the quality and source of evidence: Relationship between quality and source of evidence, levels of evidence and grades of recommendation.
Open inguinal hernia repair is associated with moderate-to-severe postoperative pain, which may delay recovery and return to activities of daily living (Simons 2018). In addition, inadequate pain control can increase unplanned admission rate and readmission after discharge home (Simons 2018). Furthermore, inadequate post-operative pain relief may lead to hyperalgesia and persistent postoperative pain (Wheeler 2019).
The PROSPECT recommendations for pain management after open inguinal hernia repair have been published previously (Joshi 2012). However, an update assessing analgesic interventions was necessary.
The updated literature strengthens the previous PROSPECT recommendations for pain management in patients undergoing open inguinal hernia repair (Joshi 2012).
The updated PROSPECT methodology further strengthens the recommendations, because it goes beyond assessment of the available evidence based solely on the simple statistical analysis (Joshi 2019).
Analgesic interventions that are not recommended for pain management in patients undergoing open inguinal hernia repair.
Overall recommendations for pain management in patients undergoing open inguinal hernia repair.