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Clifford Y. Ko, MD; Jesse E. Thompson, Jr, MD; Amelia Alcantara, CRNA, MS; Darryl Hiyama, MD

Arch Surg. 1997;132(8):874-878.

Abstract
Objective
To evaluate the use of preemptive analgesia in patients who were undergoing an operation for acute appendicitis.

Design
Double-blind, randomized control trial.

Setting
Public hospital.

Patients
Patients who presented with presumed appendicitis.

Intervention
Patients received 1 of the following treatments: group 1, preemptive analgesia with a combination of lidocaine hydrochloride and bupivacaine hydrochloride; group 2, preemptive analgesia with saline solution; or group 3, nothing.

Main Outcome Measures
The Wong-Baker FACES Pain Rating Scale, analgesic requirements, number of analgesic doses required, and length of hospital stay.

Results
No differences were noted in postoperative pain, the total number of analgesic doses per day, the quantity of narcotic medication administered, and the length of hospital stay.

Conclusions
Compared with healthy control subjects, preemptive analgesia did not reduce postoperative pain, reduce analgesic requirements, or shorten the length of hospital stay in patients who underwent an appendectomy. Preemptive analgesia may be applicable only for patients without preoperative pain.

Arch Surg. 1997;132:874-878

Author Affiliations
From the Departments of Surgery, Olive View–UCLA Medical Center, Sylmar, Calif (Drs Ko, Thompson, and Hiyama and Ms Alcantara), and UCLA Medical Center, Los Angeles, Calif (Drs Ko, Thompson, and Hiyama).

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