THE EFFICACY OF LOCAL ANAESTHESIA FOR APPENDICECTOMY

Abstract

Introduction:  Appendicitis is the acute or chronic inflammatory condition of the vermiform shaped appendix which is manifested mainly as pain in the Right Lower Quadrant (RLQ) of the abdomen, usually affecting patients aged between 5 years old and 45 years old. The prevalence of this condition is quite high, especially in developing nations. The obstructed appendiceal orifice is one of the primary pathophysiologies behind appendicitis. This occlusion of the orifice can be due to several reasons depending on factors like gender, age, race, underlying conditions, infection, etc. There are several other etiologies that can lead to appendiceal orifice including parasitic infection, benign or malignant tumour, etc. This study effectively presents the comparison between the efficacy of general anaesthesia with that of local anaesthesia in appendicectomy to avoid the complications of general anaesthesia. This study would bring the evaluation of general anaesthesia and local anaesthesia in appendicectomy.

Materials and Methods: The current study is of retrospective design and it was conducted during the period of one year two months. According  to each anaesthesia received, they were divided into 4 groups. The study classified the patients into 4 groups, namely, Group 1 to Group 4. In Group 1 patients (Control group), no local anaesthesia was used. In Group 2 patients, 1% lidocaine was given at specific site. In Group 3 patients, 5 mL of 0.5% of levo-bupivacaine was injected. In Group 4 patients, 5 mL of 0.5% ropivacaine and 10 mL of 0.5% ropivacaine was applied. The outcome was assessed by Visual Analog Scale (VAS).

Results: The study found that there is significant differences in pain intensity among Group 3 patients and Group 4 patients when compared with Group 1 patients, throughout the assessment of their pain intensity at each fixed interval. In group 1, complications like sore throat, dizziness and diificult urination were found while in group 2, group 3 and group 4 patients had similar complications but of lesser severity like vomiting, dizziness, headache and muscle twitching, etc.

Conclusion: The study revealed that significant number of patients using local anaesthesia had significantly reduced pain after the appendicectomy when compared to group 1 patients. Group 3 and Group 4 who were anaesthesized with levo-bupivacaine and ropivacaine had more efficacy in terms of pain reduction after the surgery assessed at intervals.

Keywords: appendicectomy, anaesthesia, general anaesthesia, local anaesthesia