2021 Volume 57 Issue 5 Pages 832-838
Purpose: There is currently no standardized method for the management of postoperative pain in children. We investigated the usefulness of local anesthetic infiltration (LAI) and rectus sheath block (RSB) for inducing postoperative analgesia in pediatric laparoscopic appendectomy.
Methods: We retrospectively reviewed 115 cases of pediatric emergency laparoscopic appendectomy performed from September 2009 to August 2020 on the basis of medical records. A three-port technique was initially used as the standard procedure, whereas single-port appendectomy was introduced in July 2011. For inducing postoperative analgesia, LAI was introduced from August 2013, and RSB was introduced in June 2018. The 115 cases were classified as group A (n = 57) for no postoperative analgesia and group B (n = 58) for postoperative analgesia (LAI or RSB). Group B was further divided into two groups: the group LAI (n = 38) and the group RSB (n = 20).
Results: The rate and time of reported pain immediately after returning to the ward were significantly lower in group B than in group A (p = 0.037/0.02), and the rate of reported pain immediately after returning to the ward was significantly lower in group RSB than in group LAI (p = 0.036). In contrast, there were no significant differences in time to the first complaint of pain (219.6 min vs. 204.7 min) or in the presence or absence of postoperative nausea and vomiting.
Conclusions: RSB as a nerve block had a significant early analgesic effect for postoperative analgesia in pediatric laparoscopic appendectomy.
