Laparoscopic Appendectomy versus Glove Single Port Laparoscopic Appendectomy in Pediatrics under Spinal versus General Anesthesia. A controlled Randomized Study

Abstract

Background: The glove single-port laparoscopic appendectomy it is a novel SILS technique which is extremely cheaper than the other commercial devices. Objective: this study aimed to compare between conventional laparoscopic appendectomy (CLAP) and glove single port laparoscopic appendectomy (GSPLAP) under tow different anesthetic technique. Patients and Methods: this study of laparoscopic appendectomy was conducted over thirty six children (n=36). All patients were randomized into 4 groups by a random-number table sequence after giving informed parental consent. The allocations will be contained in opaque sequentially numbered closed envelopes and every patient drew an envelope. Results: Two cases of GSPLAP were converted to multi-port due to difficult accessibility of the appendix and adhesions (suppurative appendicitis). The Mean operative time for CLAP was significantly lower than GSPLAP procedure. For CLAP was 38.39±10.12 min (ranged from 26 to 75 min) and was 49.11±11.98 min (ranged from 38 to 86 min) for GSPLAP. We observed that GSPLA was less painful significantly than CLAP for the first postoperative hours (≤3hrs) the time of postoperative needs of analgesia in pt. underwent LA under SA is delayed. Conclusion: Using a combination of 0.5% hyperbaric bupivacaine and a fentanyl provided effective anesthesia for laparoscopic appendectomy with low-pressure Co2 Pneumoperitoneum. It offers better pain management for the patients, earlier recovery and less operating room costs. We recommend an increasing use of spinal anesthesia for laparoscopic appendectomy especially in patients with risks for general anesthesia.