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The effect on postoperative pain of pulling the rectus muscle medially during open appendectomy surgery

E Turk1, N M Acimis, F Karaca

  • 1Department of Pediatric Surgery, Izmir University, Faculty of Medicine, Izmir, Turkey - eturk19@yahoo.de.

Minerva Chirurgica
|June 28, 2014
PubMed
Abstract

Insights

Medially pulling the rectus muscle during open appendectomy significantly reduced postoperative pain in children compared to splitting the muscle. This technique offers a more comfortable recovery for pediatric patients undergoing appendectomy.

Area of Science:

  • Surgical Innovation
  • Pediatric Surgery
  • Pain Management

Background:

  • Acute appendicitis is a common surgical emergency in children.
  • Traditional open appendectomy involves muscle splitting, which can lead to significant postoperative pain.
  • Minimally invasive surgical techniques are increasingly explored to improve patient outcomes.

Purpose of the Study:

  • To compare the effect of medial rectus muscle retraction versus muscle splitting on postoperative pain following open appendectomy in pediatric patients.
  • To evaluate the efficacy of a modified surgical approach in enhancing patient comfort after appendectomy.

Main Methods:

  • A prospective study involving pediatric patients (≥6 years) with acute appendicitis.
  • Patients were randomized into two groups: medial rectus muscle retraction and muscle splitting.
  • Postoperative pain was assessed using a Visual Analog Scale (VAS) at 12 and 24 hours.

Main Results:

  • The medial retraction group (31 patients) showed significantly lower VAS pain scores at 12 and 24 hours post-surgery compared to the muscle splitting group (30 patients).
  • Preoperative pain scores, age, gender, and inpatient duration were comparable between groups.
  • Statistically significant reduction in postoperative pain (P<0.05) was observed with the medial retraction technique.

Conclusions:

  • Medial rectus muscle retraction is a superior approach for open appendectomy in pediatric patients, leading to reduced postoperative pain.
  • This technique offers a more comfortable postoperative experience for children undergoing appendectomy.
  • The findings support the adoption of medial rectus muscle retraction in clinical practice for open appendectomies.

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