Combined Nerve Blockade and Local Infiltration Anesthesia in Appendectomy - A Blinded Randomized Study

Study Overview
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Brief Summary
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The purpose of this study is to assess whether the use of local anesthetic to numb the nerves that run deeper in the abdominal wall gives better post operative pain control than just infiltrating local anesthetic to the wound edges.

Detailed Description
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Local anesthetic is often administered during an operation to reduce post operative wound pain. Whilst this is frequently done during an appendectomy there is currently no evidence to suggest whether there is any benefit to the patient to injecting the local anesthetic deeper to block the nerves supplying abdominal wall sensation, compared to using it just in the skin around the wound. Comparison: Post operative pain scores following appendectomy for patients given skin infiltration of local anesthetic (pre incision), compared to patients given both preincision wound infiltration and deeper field infiltration with local anesthetic(deep to external oblique).

Official Title
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Combined Nerve Blockade and Local Infiltration Anesthesia in Appendectomy - A Blinded Randomized Study

Conditions
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Pain, Postoperative

Intervention / Treatment
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* Procedure: local anesthetic administration


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Lanz incision appendectomy as starting procedure, including those where an alternative cause for symptoms is found at operation and those where incision is later extended/changed (these may be sub grouped at time of analysis) Consent obtained Exclusion Criteria: Laparoscopic appendectomy Appendectomy at time of laparotomy/other incision
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: A<br>lanz incision appendectomy | Procedure: local anesthetic administration<br>* Pre incision skin infiltration with local anesthetic 0.5% bupivacaine by weight OR Pre incision skin infiltration and deeper field infiltration (deep to external oblique) with local anesthetic 0.5% bupivavcaine by weight<br>|
| Active Comparator: B<br>lanz incision appendectomy | Procedure: local anesthetic administration<br>* Pre incision skin infiltration with local anesthetic 0.5% bupivacaine by weight OR Pre incision skin infiltration and deeper field infiltration (deep to external oblique) with local anesthetic 0.5% bupivavcaine by weight<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post operative pain score |  | 1 hour, 4 hours, 8 hours, 24 hours and on discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post operative nausea and vomiting |  | 1 hour, 4 hours, 8 hours, 24 hours and on discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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appendicectomy, pain, local anaesthetic, nerve block, Post operative pain following appendicectomy