RANDOMIZED, SINGLE-BLINDED TRIAL OF LAPAROSCOPIC VERSUS OPEN APPENDECTOMY IN CHILDREN - EFFECTS ON POSTOPERATIVE ANALGESIA

Background: The benefit of laparoscopy to patients has been clearly es tablished in adults undergoing cholecystectomy. Results are less clear for appendectomy, The current study was undertaken to compare the res pective S-day postoperative periods after laparoscopic and open append ectomy in children, Methods: Sixty-three children (aged 8-15 yr) sched uled for appendectomy were randomly assigned to two groups: open and l aparoscopic. Postoperative evaluation included delay of postoperative recovery (walking and feeding), pain assessment by visual analog scale during the 3 subsequent days, amount of nalbuphine administered via a patient-controlled analgesia system during the first 48 h and respons es by children, patents, and nurses on the overall quality of analgesi a. Results: There was no difference between groups for demographic dat a (particularly macroscopic aspect of appendix), analgesia, sedation, delay before eating and walking, incidence of urinary retention, nause a, vomiting, Operative time was longer (P less than or equal to 0.05) in the laparoscopic group (54 +/- 17 min) than in the open group (39 /- 18 min). Thirty five percent of the children had pain at the should er in the LAP group versus ten percent in the open group (P less than or equal to 0.05). Conclusions: Laparoscopy did not improve analgesia and postoperative recovery after appendectomy in children.