Preemptive analgesia in patients undergoing appendectomy at Debaratana Nakhon Ratchasima Hospital, Thailand

Abstract

Preemptive  analgesia  through  infiltration  of  anaesthetics  into  surgical  wounds  before  the  incision  is effective in various elective surgeries. Although this application can decrease postoperative pain, it is not known whether  it  is  effective  in  surgery  with  acute  pain.  This  study,  therefore,  evaluated  whether  the  application  of a preincisional local anaesthetic decreased the postoperative pain in patients undergoing an appendectomy for acute appendicitis.

The  sample  was  seventy-five  consecutive  patients  admitted  to  Debaratana  Nakhon  Ratchasima  Hospital with  a  tentative  diagnosis  of  acute  appendicitis.  Patients  were  randomly  divided  into  two  groups.  For  group 1,  the  study  group  of  thirty-five  cases,  2%  lidocaine  with  adrenaline  (epinephrine)  1:200,000  was  injected  to the  planned  incision  site  cutaneously,  subcutaneously  under  the  fascia  of  the  external  oblique  muscle.  Group 2,  the  control  group  of  forty  cases  received  the  same  volume  of  saline  injection  to  the  anatomical  site.  One milligram per kilogram meperidine was administered intravenously to both groups for postoperative analgesia. If required, a further 0.5 mg/kg of meperidine was administered. Postoperative pain was assessed by a visual analog scale during the first 24 hr. The analgesic and the doses required were recorded. All data were stored using SPSS 11.0 for Windows. The Mann-Whitney U-test was used to compare data between the two groups when the data were in  a non-normal  distribution.

No  statistically  significant  difference  was  found  between  the  pain  scores  of  the  two  groups,  the  number of  patients  who  needed  analgesic  and  the  amount  and  number  of  doses  administered.  Preincisional  local anaesthetic infiltration did  not  decrease the  need for postoperative  analgesic use in patients  with acute pain.