Related Experiment Video
Updated: Aug 5, 2025
Acupoint Needle-Embedding Combined with Ironing Therapy for Postoperative Pain After Anal Surgery
Published on: June 23, 2023
Postoperative Pain Management in Children Undergoing Laparoscopic Appendectomy: A Scoping Review
Abdalkarem Fedgash Alsharari1, Farhan Faleh Alshammari2, Dauda Salihu1
1College of Nursing, Jouf University, Sakaka 72388, Saudi Arabia.
Insights
Managing postoperative pain (POP) in children after laparoscopic appendectomy (LA) is crucial. Multimodal analgesia and specific nerve blocks like ultrasound-guided transverse abdominis blockade (UGTAP) show promise, but more research is needed.
Area of Science:
- Pediatric Surgery
- Pain Management
- Anesthesiology
Background:
- Laparoscopic appendectomy (LA) is a common pediatric procedure causing significant postoperative pain (POP).
- Effective POP management is essential for pediatric recovery after LA.
- Current literature explores various methods for controlling POP in children undergoing LA.
Purpose of the Study:
- To investigate the effects of various methods on postoperative pain in children after laparoscopic appendectomy.
- To review and evaluate the control of POP in pediatric patients undergoing LA.
Main Methods:
- Comprehensive literature search across major databases (PubMed, Medline, Embase, Cochrane Library, Clinical Trials.gov, Google Scholar).
- Inclusion of randomized controlled trials, prospective and retrospective studies, and clinical trials without language or date restrictions.
- Independent review of 18 selected papers evaluating different POP management strategies.
Main Results:
- Laparoscopic appendectomy is preferred over open appendectomy in children.
- Multimodal analgesic approaches are optimal for POP management.
- Ultrasound-guided nerve blocks (UGTAP, UGQLB) and dexmedetomidine show potential benefits in reducing POP.
Conclusions:
- While effective POP management strategies exist for pediatric laparoscopic appendectomy, including multimodal analgesia and specific nerve blocks, further large-scale randomized controlled trials are necessary.
- The efficacy of techniques like UGTAP and UGQLB in significantly impacting POP requires more robust evidence.
- Dexmedetomidine can be a useful adjuvant for enhancing local anesthetic effects in pediatric POP management.
Abstract:
Laparoscopic appendectomy (LA) is one of the most commonly performed surgical procedures in children and is associated with extreme postoperative discomfort due to peritoneal inflammation and infection. The main objective of this study was to investigate the effects of postoperative pain (POP) in children after laparoscopic appendectomy. Articles describing or evaluating the control of POP in children with LA were considered eligible. All available literature such as randomized controls, prospective controls, retrospective as well as clinical studies were considered. A comprehensive search was performed in PubMed, Medline, Embase, Cochrane Library, Clinical trials.gov, and Google scholar. The initial search took place on 23 April 2021, and was updated on 24 August 2021. There were no language or date restrictions. Each of the included articles was evaluated separately by two independent reviewers. Additional papers were found by searching the reference lists of eligible studies. Eighteen papers were considered. All papers, and many of them used different methods to treat POP in children undergoing LA, such as lidocaine infusion, different analgesic approaches, ultrasound-guided transverse abdominis blockade (UGTAP), ultrasound-guided quadratus lumborum blockade (UGQLB), and comparison of open appendectomy (OA) with local anesthetics in relation to POP management in children. Laparoscopic appendectomy is the surgical procedure preferred by clinicians compared with open appendectomy in children. A multimodal analgesic approach is optimal and efficient surgical techniques such as UGBRSB, UGQLB, and UGTAP block might significantly impact POP in children except that there are contraindications. Dexmedetomidine proved to be an effective adjuvant that can enhance the effect of local anesthetics. The lack of a sufficient number of studies may be a factor affecting our confidence in the results of this study. Therefore, further evidence-based randomized control trials with a large sample size are needed to provide clarity.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD: