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Incisional local anaesthesia versus placebo for pain relief after appendectomy in children--a double-blinded

S I Jensen1, M Andersen, J Nielsen

  • 1Surgical Department A, Odense University Hospital, 5000 Odense C, Denmark.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|January 5, 2005
PubMed

Insights

Incisional bupivacaine infiltration did not significantly reduce morphine use in children after open appendectomy. While pain relief trended longer, the difference was not statistically significant in this randomized controlled trial.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Incisional local anesthesia is a common method for managing postoperative pain.
  • Bupivacaine is a frequently used local anesthetic for surgical procedures.

Purpose of the Study:

  • To evaluate the efficacy of incisional bupivacaine infiltration versus placebo for postoperative pain relief in children undergoing open appendectomy.
  • To determine if bupivacaine reduces the need for opioid analgesics in the early postoperative period.

Main Methods:

  • A double-blinded, randomized controlled study was conducted with 68 pediatric patients undergoing open appendectomy.
  • Patients received either bupivacaine infiltration (0.5 ml/kg, 0.25% or 0.5% concentration based on weight) or a placebo into the subcutis after wound closure.
  • Postoperative morphine consumption and pain duration were assessed over the first 24 hours.

Main Results:

  • There was no statistically significant difference in average morphine consumption between the bupivacaine group (0.065 mg/kg) and the placebo group (0.073 mg/kg) within the first 24 hours.
  • Patients receiving bupivacaine showed a trend towards longer pain relief duration, but this difference was not statistically significant.

Conclusions:

  • Subcutaneous infiltration of bupivacaine in the wound following open appendectomy in children did not significantly impact morphine utilization in the first postoperative day.
  • Further research may be warranted to explore optimal concentrations or alternative methods for enhancing the analgesic effect of local anesthetics in pediatric appendectomy patients.

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