To investigate the risk factors for early postoperative pain following giant incisional hernia repair of the abdominal wall.

Clinical data of 252 patients who underwent giant incisional hernia repair in the Hernia and Abdominal Wall Specialty Group of the Department of Colorectal Surgery, Drum Tower Hospital Affiliated to Nanjing University School of Medicine, from January 2018 to December 2021, were collected. The Visual Analogue Scale (VAS) was utilized to assess the intensity of postoperative pain. Based on the occurrence of early postoperative pain, patients were divided into the observation group (VAS score ≥4 within 3 days post-surgery) and the control group (VAS score <4 within 3 days post-surgery). Univariate analysis was conducted on factors potentially causing early postoperative pain. Factors significant in the univariate analysis were further analyzed using logistic multivariate regression to identify independent influencing factors for early postoperative pain.

Early postoperative pain occurred in 32 patients (12.70%) of the 252 patients who underwent repair of large incisional hernia. Significant differences were found between the two groups in terms of age, preoperative white blood cell count, preoperative albumin, primary hypertension, history of alcohol consumption, and postoperative constipation (P<0.1). Univariate analysis indicated that age (OR=0.962, P=0.009), preoperative albumin (OR=0.831, P<0.001), and primary hypertension (OR=0.162, P=0.001) were related to early postoperative pain. Further multivariate logistic regression analysis revealed that age (OR=0.963, P=0.033), preoperative albumin (OR=0.780, P<0.001), primary hypertension (OR=0.100, P=0.001), and postoperative constipation (OR=4.340, P=0.018) were independent influencing factors for early postoperative pain.

Low age, low preoperative albumin levels, no primary hypertension, and postoperative constipation are independent risk factors for early postoperative pain. For patients undergoing giant incisional hernia repair of the abdominal wall, timely intervention measures can be taken for those with high-risk factors to prevent and treat early postoperative pain.