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Laparoscopic appendectomy is a very common intervention in pediatric surgery. To improve outcomes, some teams have developed the use of single-site laparoscopic appendectomy (SILAP). Nevertheless, there is no consensus yet and no published data on the better perioperative analgesia, and different modalities including general intravenous analgesia, locoregional pre-operative analgesia and local analgesia can be used.
The aim of this retrospective study is to describe the different types of perioperative analgesia routinely used and to compare them to determine the more efficient one for early postoperative pain relief.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SILAP patients | This cohort is composed by all pediatric patients operated on for SILAP between January 1st, 2012 and August 31, 2022. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SILAP (single incision laparoscopic appendectomy) | Procedure | Appendectomy performed through transumbilical single access laparoscopy, consisting in the removal of the appendix. |
|
| Measure | Description | Time Frame |
|---|---|---|
| To assess the level of pain after SILAP during the 24 first hours after surgery. | Objectified by the quantity of level 2-3 (in morphin equivalent) analgesic used up to 24 hours after surgery. | Up to 16 years of age. From the date of surgery until the end of hospital stay, assessed up to 16 years of age |
| Measure | Description | Time Frame |
|---|---|---|
| To assess the level of pain as measured by the different pain scales routinely used. | Objectified by the higher level of pain quoted during the first 24 hours after surgery. | Up to 16 years of age. From the date of surgery until the end of hospital stay, assessed up to 16 years of age |
| To assess the level of pain during the initial post-operative recovery room stay. |
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Inclusion Criteria:
Exclusion Criteria:
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All pediatric patients operated on by single-site access for laparoscopic appendectomy.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jeanne Goulin, MD | Contact | +33 2 41 35 42 90 | jeanne.goulin@chu-angers.fr | |
| Françoise Schmitt, MD-PhD | Contact | +33 2 41 35 42 90 | FrSchmitt@chu-angers.fr |
| Name | Affiliation | Role |
|---|---|---|
| Françoise Schmitt, MD, PhD | University hospital of Angers | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Angers University Hospital | Angers | 49933 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33848830 | Background | Goodman LF, Lin AC, Sacks MA, McRae JJLH, Radulescu A, Khan FA. Single site versus conventional laparoscopic appendectomy: some pain for no gain? J Surg Res. 2021 Aug;264:321-326. doi: 10.1016/j.jss.2021.03.010. Epub 2021 Apr 10. | |
| 29370892 | Background | Binet A, Braik K, Lengelle F, Laffon M, Lardy H, Amar S. Laparoscopic one port appendectomy: Evaluation in pediatric surgery. J Pediatr Surg. 2018 Nov;53(11):2322-2325. doi: 10.1016/j.jpedsurg.2017.12.018. Epub 2017 Dec 27. |
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| ID | Term |
|---|---|
| D001064 | Appendicitis |
| D000377 | Agnosia |
| D010146 | Pain |
| ID | Term |
|---|---|
| D059413 | Intraabdominal Infections |
| D007239 | Infections |
| D005759 | Gastroenteritis |
| D005767 | Gastrointestinal Diseases |
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Objectified by the higher level of pain quoted during the first 24 hours after surgery and by the amount of level 2-3 analgesic used. |
| Up to 16 years of age. From the date of surgery until the end of hospital stay, assessed up to 16 years of age |
| To assess the level of pain after the 24 first hours and until hospital release. | Objectified by the higher level of pain quoted from 24 hours post-operative to hospital discharge, and by the amount of level 2-3 analgesic used. | Up to 16 years of age. From the date of surgery until the end of hospital stay, assessed up to 16 years of age |
| To assess the different peri-operative local and loco-regional analgesia modalities used and to compare their efficiency. | Objectified by the amount of level 2-3 analgesics used in post-operative recovery room and during hospital stay. | Up to 16 years of age. From the date of surgery until the end of hospital stay, assessed up to 16 years of age |
| To assess the types and gravity of peri-operative and post-analgesia complications. | Objectified by the description of complications encountered and classified with the Clavien and Dindo gravity scale for surgical complications. | Up to 16 years of age. From the date of surgery until the end of hospital stay, assessed up to 16 years of age |
| D004066 |
| Digestive System Diseases |
| D002429 | Cecal Diseases |
| D007410 | Intestinal Diseases |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |