Single-blind randomized clinical trial of laparoscopic versus open appendicectomy in children

被引:93
作者
Lintula, H
Kokki, H
Vanamo, K
机构
[1] Kuopio Univ Hosp, Dept Anaesthesiol & Intens Care, FIN-70211 Kuopio, Finland
[2] Kuopio Univ Hosp, Dept Paediat Surg, FIN-70211 Kuopio, Finland
关键词
D O I
10.1046/j.1365-2168.2001.01723.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Appendicectomy is the most common emergency surgical operation in children. The aim of this study was to compare recovery after appendicectomy using either a laparoscopic or an open technique in children. Methods: Sixty-one children aged 4-15 years undergoing appendicectomy for suspected uncomplicated appendicitis were studied. The study was prospective, randomized and single-blinded, with parallel groups. Standardized anaesthetic technique and pain management were used. The study endpoints were postoperative pain, need for rescue analgesia, and length of hospital stay. Results: Children had significantly less pain after laparoscopic compared with open appendicectomy 8 h after operation and on the first and second postoperative mornings (P<0.05). Laparoscopic appendicectomy resulted in a reduced requirement for rescue analgesia with oxycodone in hospital: mean(s.d.) 3.6(2.5) versus 5.8(3.3) doses (mean difference 2.2 doses, 95 per cent confidence interval (c.i.) 0.6-3.8 doses); P=0.01. The mean(s.d.) length of hospital stay was significantly shorter in the laparoscopic group: 1.9(0.7) versus 2.6(0.9) days (mean difference 0.7 days, 95 per cent c.i. 0.3-1.1 days); P=0.001. Three children who had open appendicectomy developed a wound infection. Conclusion: Laparoscopic appendicectomy is associated with less postoperative pain and a shorter hospital stay than open appendicectomy in children undergoing surgery for uncomplicated appendicitis.
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页码:510 / 514
页数:5
相关论文
共 12 条
[1]  
Blakely M L, 1998, Semin Pediatr Surg, V7, P225
[2]  
Blakely Martin L., 1998, Current Opinion in Pediatrics, V10, P315, DOI 10.1097/00008480-199806000-00017
[3]   Factors that influence length of stay after appendicectomy in children [J].
Foulds, KA ;
Beasley, SW ;
Maoate, K .
AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY, 2000, 70 (01) :43-46
[4]  
Hay SA, 1998, PEDIATR SURG INT, V13, P21
[5]   Peroperative treatment with i.v. ketoprofen reduces pain and vomiting in children after strabismus surgery [J].
Kokki, H ;
Homan, E ;
Tuovinen, K ;
Purhonen, S .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 1999, 43 (01) :13-18
[6]   The effect of intravenous ketoprofen on postoperative epidural sufentanil analgesia in children [J].
Kokki, H ;
Tuovinen, K ;
Hendolin, H .
ANESTHESIA AND ANALGESIA, 1999, 88 (05) :1036-1041
[7]   A state wide evaluation of appendectomy in children [J].
Kokoska, ER ;
Murayama, KM ;
Silen, ML ;
Miller, TA ;
Dillon, PA ;
Weber, TR .
AMERICAN JOURNAL OF SURGERY, 1999, 178 (06) :537-540
[8]   PATIENT-CONTROLLED ANALGESIA IN CHILDREN [J].
LAWRIE, SC ;
FORBES, DW ;
AKHTAR, TM ;
MORTON, NS .
ANAESTHESIA, 1990, 45 (12) :1074-1076
[9]   Randomized, single-blinded trial of laparoscopic versus open appendectomy in children - Effects on postoperative analgesia [J].
Lejus, C ;
Delile, L ;
Plattner, V ;
Baron, M ;
Guillou, S ;
Heloury, V ;
Souron, R .
ANESTHESIOLOGY, 1996, 84 (04) :801-806
[10]   Analgesic efficacy of paracetamol and diclofenac in children receiving PCA morphine [J].
Morton, NS ;
O'Brien, K .
BRITISH JOURNAL OF ANAESTHESIA, 1999, 82 (05) :715-717