Local anaesthetic wound infiltration following paediatric appendicectomy: a randomised controlled trial: Time to stop...

Area of Science:

• Pediatric Surgery
• Anesthesiology
• Pain Management

Background:

• Appendicectomy is a common surgical procedure in children.
• Effective post-operative pain management is crucial for pediatric surgical recovery.
• Local anaesthetic wound infiltration is a technique used to reduce post-operative pain.

Purpose of the Study:

• To evaluate the effectiveness of local anaesthetic wound infiltration in managing post-operative pain following paediatric appendicectomy.
• To compare bupivacaine infiltration with saline and no infiltration in reducing pain and analgesic needs.
• To assess adverse wound outcomes associated with local anaesthetic infiltration.

Main Methods:

• A prospective, randomized, controlled clinical trial was conducted.
• Children aged 5-16 years undergoing appendicectomy were randomized into three groups: bupivacaine infiltration, saline infiltration, or no infiltration.
• Pain scores, analgesic requirements, and wound outcomes were assessed over 20 hours post-operatively. Patients and observers were blinded.

Main Results:

• Eighty-eight children participated, with no significant differences in baseline characteristics between groups.
• No statistically significant differences were observed in mean post-operative pain scores among the three groups.
• There were no significant differences in the need for additional post-operative analgesia between the bupivacaine, saline, and no infiltration groups.

Conclusions:

• Local anaesthetic wound infiltration does not provide additional pain relief benefits compared to standard analgesia after paediatric appendicectomy.
• The routine use of local anaesthetic wound infiltration for this procedure in children is not supported by current evidence and should be reconsidered.
• Further research may be warranted to explore alternative or adjunct pain management strategies for pediatric appendicectomy.