Comparison of Post-Operative Pain Score Between Open Appendectomy and Laparoscopic Appendectomy on Acute Appendicitis Patient in Siloam Hospital Lippo Village
DOI:
https://doi.org/10.19166/med.v11i1.7362Keywords:
Acute appendicitis, Post-operative pain, Open appendectomy, Laparoscopic appendectomyAbstract
Background: Appendicitis is inflammation of vermiform appendix which can be caused by luminal obstruction. Appendicitis is one of the most common causes of emergency abdominal surgery, with 11 cases per 10.000 person per year. Until today, open appendectomy is still the gold standard for appendicitis treatment although laparoscopic appendectomy has significantly lower post-operative pain.
Methods: This study uses cross-sectional study design with post-open appendectomy and laparoscopic appendectomy patients in Siloam Hospital Lippo Village as the sample population. The Visual Analogue Scale (VAS) is taken from patient’s medical record and processed using Mann-U-Whitney test.
Result: From 70 acute appendicitis patients, 36 underwent open appendectomy and 34 underwent laparoscopic appendectomy. The result showed the median score of VAS 1 day post open appendectomy surgery (median = 3, min/max = 2/6 [95% CI = 2,55 - 3,14]) is higher than post laparoscopic appendectomy (median = 2,25, min/max = 0/4, [95% CI = 1,97 - 2,59]), with adjusted p value against age and surgery duration is 0,024. In pediatric patients, median score of VAS 1 day post open appendectomy surgery is the same with laparoscopic appendectomy (median = 3, p value = 0,863). Multivariate analysis showed that surgery duration affects VAS 1 day post appendectomy surgery in pediatric patients (p value = 0,042).
Conclusions: This study shows that the median score of VAS 1 day post open appendectomy surgery is higher than laparoscopic appendectomy. This result is statistically significant. However, in pediatric patients the median score of VAS 1 day post open appendectomy surgery and laparoscopic appendectomy is the same. VAS 1 day post appendectomy surgery in pediatric patients is affected by surgery duration.
References
1. Dahdaleh FS, Heidt D, Turaga KK. The Appendix. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Kao LS, Hunter JG, et al., editors. Schwartz’s Principles of Surgery, 11e. New York, NY: McGraw-Hill Education; 2019.
2. Jacobs DO. Acute Appendicitis and Peritonitis. In: Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine, 20e. New York, NY: McGraw-Hill Education; 2018.
3. Soepardi J. Jendela Data dan Informasi Kesehatan Penyakit Tidak Menular. Kementerian Kesehatan RI. Jakarta: Kementerian Kesehatan RI; 2012.
4. Biondi A, Di Stefano C, Ferrara F, Bellia A, Vacante M, Piazza L. Laparoscopic versus open appendectomy: A retrospective cohort study assessing outcomes and cost effectiveness. World J Emerg Surg. 2016;11(1):4-9. https://doi.org/10.1186/s13017-016-0102-5
5. Goyal DV, Gupta DM, Rhezhii DD. What is gold standard for Appendicectomy? Open or laparoscopic. Int J Med Res Rev. 2015; 3(9):1090-5. https://doi.org/10.17511/ijmrr.2015.i9.198
6. Gupta A, Kaur K, Sharma S, Goyal S, Arora S, Murthy RSR. Clinical aspects of acute post-operative pain management & its assessment. J Adv Pharm Technol Res. 2010 Apr;1(2):97-108. https://pubmed.ncbi.nlm.nih.gov/22247838
7. Wells N, McCaffery CP and M. Improving the Quality of Care Through Pain Assessment and Management. In: Patient Safety and Quality: An Evidence-Based Handbook for Nurses. 2004.
8. Çiftçi F. Laparoscopic vs mini-incision open appendectomy. World J Gastrointest Surg. 2015 Oct 27;7(10):267-72. https://doi.org/10.4240/wjgs.v7.i10.267
9. Cipe G, Idiz O, Hasbahceci M, Bozkurt S, Kadioglu H, Coskun H, et al. Laparoscopic versus open appendectomy: Where are we now? Chir. 2014;109(4):518-22.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website). The final published PDF should be used and bibliographic details that credit the publication in this journal should be included.