Perioperative pain management for appendicectomy: A systematic review and Procedure-specific Postoperative Pain Management recommendations
Methodological detailsPROSPECT methodology, PRISMA search, evidence and consensus
- PROSPECT methodology
- PRISMA search
- Evidence and consensus
Recommendations
As issued by the authors
Basic analgesics (paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs)) perioperatively for open and laparoscopic appendicectomies
Laparoscopic approach preferred because of lower pain scores
Laparoscopic appendicectomy: three-port laparoscopic approach and intraperitoneal local anaesthetic instillation
Open appendicectomy: preoperative unilateral transverse abdominis plane (TAP) block; if not possible, preincisional local anaesthetic infiltration as alternative
Opioids only as rescue analgesia
Limited evidence for TAP block in laparoscopic appendicectomy, analgesic adjuvants for TAP block, continuous wound infiltration after open appendicectomy and preoperative ketamine and dexamethasone
Recommendations apply to children and adults
Original publication
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