Preemptive analgesia application in acute appendicitis

BACKGROUND: Preemptive analgesia with infiltration of anesthetics into surgical wounds before the incision has been shown to be effective in various elective surgeries. Although this application can decrease the postoperative pain, it is not known whether it is effective in surgery with acute pain or not.
AIMS: In this study, we evaluated whether the preincisional local anesthetic application will decrease the postoperative pain in patients undergoing appendectomy for acute appendicitis.
MATERIALS AND METHODS: Forty consecutive patients admitted to the Emergency Department with a tentative diagnosis of acute appendicitis were randomly divided into two groups. In Group 1, 1% prilocaine and 0.25% bupivacaine was injected to the planned incision site cutaneously, subcutaneously, and under the fascia of the external oblique muscle. The patients in Group 2 received the same volume of saline to the same anatomical sites. Initially, 1 mg/kg meperidine was administered intramuscularly to both groups for postoperative analgesia. If needed further, meperidine 0.5 mg/kg was administered intramuscularly. Postoperative pain was assed by visual analog scale during the first 24 hours. The analgesic needed and the doses required were recorded.
STATISTICAL ANALYSES: All data were stored using SPSS 11.0 for Windows. Wilcoxon test and two independent samples T-test was used as the non-parametric test.
RESULTS AND CONCLUSIONS: No statistically significant difference was found between the two groups' pain score, the number of patients who needed analgesic, and the amount and the number of doses administered. In conclusion, we think that preincisional local anesthetic infiltration does not help to decrease the need for postoperative analgesic use in patients with acute pain, and this may be related with previous central sensitization.