Pain after single-incision versus conventional laparoscopic appendectomy: a propensity-matched analysis.

Abstract

BACKGROUND:

The aim of this study was to compare postoperative pain outcomes between single-incision laparoscopic appendectomy (SILA) and conventional laparoscopic appendectomy (CLA) using a propensity score matching analysis.

MATERIALS AND METHODS:

Adult patients who underwent SILA or CLA for acute appendicitis between January 2010 and December 2015 at a single center were identified retrospectively from a prospectively collected database. All patients had used an intravenous patient-controlled analgesia (PCA) device for postoperative pain control. As potential confounding variables, patient characteristics and surgery-related, anesthesia-related, and PCA-related factors were collected from the database. The primary outcome was the postoperative pain score, and secondary outcomes were nausea, vomiting, rescue analgesic use, rescue antiemetic use, and PCA-related complications. These outcomes were compared between the SILA and CLA groups before and after 1:1 propensity score matching.

RESULTS:

From a total of 915 patients, 753 were selected: 116 in the SILA group and 637 in the CLA group. After propensity score matching, two comparable groups with 111 patients each were obtained. Pain score (P = 0.007) and rescue analgesic use (P = 0.043) on the day of surgery were significantly lower in the SILA group than in the CLA group. The other outcomes were similar between the two groups.

CONCLUSIONS:

SILA is a beneficial surgical procedure for postoperative pain management.

• Authors: Geun Joo Choi, Hyun Kang, Beom Gyu Kim, Yoo Shin Choi, Jin Yun Kim, Sangseok Lee
• Journal: The Journal of surgical research (J Surg Res) Vol. 212 Pg. 122-129 (05 15 2017) ISSN: 1095-8673 [Electronic] United States
• PMID: 28550898 (Publication Type: Comparative Study, Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2017 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Analgesia, Patient-Controlled
• Appendectomy (methods)
• Appendicitis (surgery)
• Female
• Humans
• Laparoscopy (methods)
• Male
• Middle Aged
• Pain, Postoperative (drug therapy, prevention & control)
• Propensity Score
• Retrospective Studies
• Treatment Outcome