Appendicitis, Pain, Postoperative
Conditions
Keywords
appendicitis, postoperative pain, patient satisfaction, children, pediatric, narcotic, pain control
Brief summary
There is concern that pain prescription after outpatient pediatric surgical procedures is excessive and is in excess of patient need. Current practice following pediatric appendectomy is to prescribe all children with 5-15 doses of narcotic pain medication upon discharge regardless of their age, severity of appendicitis, or pain control in the hospital. This study examines the amount of narcotic pain control required by pediatric patients after undergoing appendectomy using a randomized controlled trial study design. Pain control will be assessed with a post-operative pain scale, patient satisfaction survey, and parent satisfaction survey on the days following surgery and at post-operative follow-up. The hypothesis is that the pain scores and patient satisfaction surveys will show no difference in post-operative pain control between the two arms.
Detailed description
There is concern that pain prescription after outpatient pediatric surgical procedures is excessive and is in excess of patient need. Current practice following pediatric appendectomy is to prescribe all children with 5-15 doses of narcotic pain medication upon discharge regardless of their age, severity of appendicitis, or pain control in the hospital. This study examines the amount of narcotic pain control required by pediatric patients after undergoing appendectomy using a randomized controlled trial study design. Children admitted after undergoing surgical management for a diagnosis of acute appendicitis will be randomized at discharge to a narcotic arm or a tylenol/motrin arm. The narcotic arm will receive the standard of care narcotic prescription. The tylenol/motrin arm will receive education to use tylenol and motrin for pain control as well as a paper prescription provided for the sole purpose of rescue. Pain control will be assessed with a post-operative pain scale, patient satisfaction survey, and parent satisfaction survey on the days following surgery and at post-operative follow-up. The hypothesis is that the pain scores and patient satisfaction surveys will show no difference in post-operative pain control between the two arms.
Interventions
DRUGNon-narcotic pain control
Education to use tylenol and motrin only for pain control unless this is unable to control pain. Rescue prescription provided.
Sponsors
Primary Children's Hospital
University of Utah
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
No minimum to 18 Years
Healthy volunteers
No
Inclusion criteria
* Children ages 0 to 18 years old * Patients have undergone appendectomy by any technique (open, laparoscopic, single-port)
Exclusion criteria
* Patients on chronic opioids * Patient undergoes a more extensive or additional procedures at the time of operation due to complications or other indication * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Parental pain control satisfaction using Parental Post-operative Pain Measure (PPPM) | 2-week follow-up visit | Parental satisfaction with pain control at home following pediatric appendectomy as assessed by the validated Parental Post-operative Pain Measure (PPPM) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient pain control satisfaction using adaptation of Parental Post-operative Pain Measure (PPPM) | Changes from in-hospital, days 1-3 following discharge, and 2-week follow-up | Patient satisfaction with pain control at home following pediatric appendectomy as assessed by an adaptation of Parental Post-operative Pain Measure (PPPM) |
| Patient pain scores using Wong-Baker Faces Pain Rating Scale | Changes from in-hospital, days 1-3 following discharge, and 2-week follow-up | Patient description of pain control using validated Wong-Baker Faces Pain Rating Scale. This scale presents the subject with a series of 6 depictions of faces and a text description of pain level. The range is from 0 No Hurt to 10 Hurts Worst. |
| Parental pain control satisfaction using Parental Post-operative Pain Measure (PPPM) | Changes from in-hospital, days 1-3 following discharge, and 2-week follow-up | Parental satisfaction with pain control at home following pediatric appendectomy as assessed by Parental Post-operative Pain Measure (PPPM) |
| Days of pain medication requirement after discharge | Post-operative days 1-14 (until follow-up) | Number of days patient required pain medication |
| Number of pain medication side effects | Post-operative days 1-14 (until follow-up) | Side effects experienced by taking pain medications following surgery |
| Number of pain medications used | Post-operative days 1-14 (until follow-up) | Number of pain medications used |
Countries
United States
Outcome results
None listed