Rectus sheath block for laparoscopic appendicectomy: a randomized clinical trial

Area of Science:

• Pediatric Anesthesiology
• Surgical Pain Management
• Acute Care Surgery

Background:

• Rectus sheath block efficacy is established in elective pediatric surgery.
• Limited data exists on its use in acute laparoscopic procedures.
• Investigated rectus sheath block for pain post-laparoscopic appendicectomy.

Purpose of the Study:

• To evaluate the effectiveness of rectus sheath block in reducing pain after laparoscopic appendicectomy in children.
• To compare pain scores, opiate use, and recovery metrics between the block and control groups.

Main Methods:

• Randomized clinical trial involving children aged 8-14 years.
• Comparison of rectus sheath block (bupivacaine plus adrenaline) versus saline control.
• Primary outcomes: pain scores and opiate use; Secondary outcomes: PACU time, hospitalization duration, and recovery.

Main Results:

• Significantly lower global pain scores in the first 3 hours post-surgery for the nerve block group (mean 2.22 vs. 3.94, P=.008).
• No significant difference in pain scores after 3 hours between groups.
• No differences observed in opiate requirements, hospital stay, or recovery post-discharge.

Conclusions:

• Rectus sheath block effectively reduces early post-operative pain in children undergoing acute laparoscopic appendicectomy.
• The block can be a valuable component of multimodal recovery strategies for pediatric surgical patients.