Substantial postoperative pain is common among children undergoing laparoscopic appendectomy

Abstract

Laparoscopic appendectomy is one of the most common surgical procedures performed in children. However, to our knowledge, the postoperative pain experience of children undergoing laparoscopic appendectomy has never been described. In this study, we assessed the postoperative pain experience of children undergoing laparoscopic appendectomy. A retrospective chart review of children aged 9-17 years undergoing laparoscopic appendectomy at a large academic medical center from 2004 to 2010 was performed. Demographic and clinical characteristics and self-reported pain scores (0-10 numeric rating scale) during hospitalization were abstracted from the medical record. Pain scores ≥4 were classified as moderate or severe. If ≥60% of pain ratings were moderate or severe during a specified time period (e.g., particular postoperative day), then the child was defined as experiencing substantial pain during that time. Pain outcomes were summarized using descriptive statistics. Secondary analyses assessed the predictors of substantial postoperative pain. Hundred and eighty-six children underwent laparoscopic appendectomy during the study period. One in three children experienced substantial postoperative pain on the day of surgery, and one in five children continued to have substantial pain the next day. Commonly available clinical and demographic characteristics were poor predictors of substantial postoperative pain. These preliminary data suggest that substantial postoperative pain is common in children undergoing laparoscopic appendectomy. More studies of postoperative pain outcomes among children undergoing laparoscopic appendectomy and other common pediatric surgical procedures are needed.