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Published on: November 6, 2019
Intraperitoneal Local Anesthetic for Laparoscopic Appendectomy in Children: A Randomized Controlled Trial
James K Hamill1, Andrew Liley, Andrew G Hill
1*Department of Pediatric Surgery, Starship Children's Hospital, Auckland, New Zealand †Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ‡Department of Anesthesia, Starship Children's Hospital, Auckland, New Zealand §South Auckland Clinical School, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Intraperitoneal local anesthetic (IPLA) did not reduce pain after pediatric laparoscopic appendectomy. This study found no clinical benefit, and IPLA is not recommended for this procedure in children.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Pain Management
Background:
- Intraperitoneal local anesthetic (IPLA) is effective for post-operative pain in adults undergoing elective surgery.
- Limited data exists on IPLA's efficacy in acute pediatric inflammatory conditions, such as appendicitis.
Purpose of the Study:
- To evaluate the effectiveness of intraperitoneal local anesthetic (IPLA) in reducing post-operative pain in children undergoing acute laparoscopic appendectomy.
- To determine if IPLA improves recovery parameters and reduces opioid use in this pediatric surgical population.
Main Methods:
- A randomized controlled trial involving children aged 8-14 years undergoing laparoscopic appendectomy.
- Participants received either bupivacaine (IPLA group) or saline (control group) atomized onto the peritoneum.
- Blinded assessment of pain scores, opioid consumption, and recovery outcomes.
Main Results:
- No statistically significant difference in overall pain scores between the IPLA and control groups.
- No significant differences observed in site-specific pain, opioid use, recovery, or complication rates.
- No complications related to the IPLA intervention were reported.
Conclusions:
- Intraperitoneal local anesthetic (IPLA) provides no clinical benefit for children undergoing acute laparoscopic appendectomy.
- IPLA cannot be recommended as an effective pain management strategy in this specific pediatric surgical context.
