Abstract

INTRODUCTION

The aim of this study is to show the results of the implementation of a multimodal pain therapy regimen consisting of preemptive and infiltration analgesia application to laparoscopic or open appendectomy in pediatric patients.

METHODS

Eighty pediatric patients with diagnosis of acute and perforate appendicitis, who underwent laparoscopic or open appendectomy were randomly separated into 2 groups of 40 to be operated with laparoscopic or open surgical technique. The age, sex, weight, duration of anesthesia and surgical techniques were recorded. Preemptive 1.5mg/kg Tramadol HCl was administered at induction of anesthesia. As infiltration anesthesia 1mg/kg 0.5% bupivacaine HCl was administered to the incision area of all patients. The pain levels of the patients after extubation were evaluated with Children's Hospital of Eastern Ontorio Pain Scale and Visual Analog Scale. The heart rates, respiratory rates, sedation score values, diastolic and systolic blood pressure values,p ostoperative analgesic requirements, sedation scores, the observed side effects, hospital stay, and the time of first mobilization were recorded and compared.

RESULTS

There were no statistically significant differences between the groups on following parameters except operation time and enesthesia time. Postoperative first day 13 patient (32,5%) in LA group and in 9 patient (22,5%) in OA group required additional analgesia while second day only 2 patient (%5) which were in the OA group.

DISCUSSION AND CONCLUSION

Our multimodal analgesia protocol consisting of preemptive analgesia and perioperative local anesthesia infiltration showed no difference between patients who underwent laparoscopic or open appendectomy in respect of pain levels and analgesic requirements.