Won Jong Kim1, Ji Yeon Mun1, Hee Ju Kim1, Sung-Hoon Yoon2, Seung-Rim Han1, Jung Hoon Bae1, In Kyu Lee1, Yoon Suk Lee1, Do Sang Lee1, Chul Seung Lee3,4. 1. Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. 2. Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 3. Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. lcscolonoscopy@gmail.com. 4. Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea. lcscolonoscopy@gmail.com.
Abstract
PURPOSE: This study aimed to evaluate the impact of multimodal postoperative pain management, performing a surgical rectus sheath (RS) block via ropivacaine injection into the surgical field after single-incision laparoscopic appendectomy (SILA). METHODS: Patients who underwent single-incision laparoscopic appendectomy (SILA) for acute appendicitis were divided into three groups and compared: group 1 (multimodal pain management that included intraoperative application of a surgical RS block), group 2 (conventional pain management with intravenous opioids), or group 3 (multimodal pain management without RS block). Forty, 53, and 42 patients were registered, respectively (Table 1). RESULTS: Time to start a liquid (1.2 ± 0.4 h) in group 1 was statistically significantly shorter than that in group 2 (16.3 ± 8.4 h; p < 0.001) and group 3 (4.93 ± 2.3 h; p < 0.001). The median and max postoperative VAS scores in group 1 (1.6 ± 1.2 and 2.2 ± 1.8, respectively) were statistically significantly lower than that in group 2 (3.0 ± 1.2 and 4.2 ± 1.9, respectively; p < 0.001 on both accounts) and group 3 (2.9 ± 0.6 and 3.4 ± 1.2, respectively; p < 0.001 on both accounts). The postoperative hospital stay for group 1 (17.0 ± 9.4 h) was shorter than that for group 2 (44.7 ± 27.9 h; p < 0.001) and group 3 (35.4 ± 20.9 h; p < 0.001). RS block was a significant factor for reducing length of hospital stay and postoperative pain in 24 h. CONCLUSIONS: A surgical RS block combined with multimodal pain management after SILA is a safe and effective method that results in reduced postoperative pain and shorter hospitalization.
PURPOSE: This study aimed to evaluate the impact of multimodal postoperative pain management, performing a surgical rectus sheath (RS) block via ropivacaine injection into the surgical field after single-incision laparoscopic appendectomy (SILA). METHODS: Patients who underwent single-incision laparoscopic appendectomy (SILA) for acute appendicitis were divided into three groups and compared: group 1 (multimodal pain management that included intraoperative application of a surgical RS block), group 2 (conventional pain management with intravenous opioids), or group 3 (multimodal pain management without RS block). Forty, 53, and 42 patients were registered, respectively (Table 1). RESULTS: Time to start a liquid (1.2 ± 0.4 h) in group 1 was statistically significantly shorter than that in group 2 (16.3 ± 8.4 h; p < 0.001) and group 3 (4.93 ± 2.3 h; p < 0.001). The median and max postoperative VAS scores in group 1 (1.6 ± 1.2 and 2.2 ± 1.8, respectively) were statistically significantly lower than that in group 2 (3.0 ± 1.2 and 4.2 ± 1.9, respectively; p < 0.001 on both accounts) and group 3 (2.9 ± 0.6 and 3.4 ± 1.2, respectively; p < 0.001 on both accounts). The postoperative hospital stay for group 1 (17.0 ± 9.4 h) was shorter than that for group 2 (44.7 ± 27.9 h; p < 0.001) and group 3 (35.4 ± 20.9 h; p < 0.001). RS block was a significant factor for reducing length of hospital stay and postoperative pain in 24 h. CONCLUSIONS: A surgical RS block combined with multimodal pain management after SILA is a safe and effective method that results in reduced postoperative pain and shorter hospitalization.
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