{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T18:10:24Z","timestamp":1758823824925},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,7,4]],"date-time":"2016-07-04T00:00:00Z","timestamp":1467590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Departmental resources"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patient\u2010controlled analgesia (<jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content>) is commonly used after appendicectomy in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to characterize the analgesic use of children prescribed <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> after appendicetomy, in order to rationalize future use of this modality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively audited all cases of acute appendicitis over a 4\u2010year period in a single pediatric hospital, recording demographics, surgical approach, pathology, analgesia use, pain scores, and duration of <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content>. We preplanned subgroup analyses for surgical approach, pathology, and intraoperative nonsteroidal anti\u2010inflammatory drug (<jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>) administration. We subsequently identified a patient subgroup who were unlikely to require <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> and conducted a (2 months) prospective audit of such patients (uncomplicated appendicitis with intraoperative <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>) having non\u2010<jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> (oral) analgesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 649 patients undergoing appendicectomy for acute appendicitis, 85% were prescribed an opioid <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content>, 8% received an opioid infusion (younger patients), and 7% received neither <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> nor infusion. Of the 541 bolus only <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> patients, 49% had laparoscopic surgery, 36% had complicated appendicitis, and 49% received intraoperative <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content> (diclofenac). Mean (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) duration of <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> was shorter with uncomplicated vs complicated appendicitis (21.9 \u00b1 10.7 vs 32.8 \u00b1 21.1 h, <jats:italic>P<\/jats:italic> &lt; 0.001, difference in means [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 10.9 [7.7\u201314.1]), and with intraoperative <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content> (23.2 \u00b1 14.4 vs 28.4 \u00b1 17.4 h, <jats:italic>P<\/jats:italic> &lt; 0.001, difference in means [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 5.2 [2.5\u20137.9]). There was no difference in the time to <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> cessation between laparoscopic and open approach. Morphine consumption and pain scores were lower in the early postoperative period for those patients receiving intraoperative <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>. In the prospective audit, 44 of 69 patients had uncomplicated appendicitis. Thirty\u2010eight of these were prescribed oral analgesia and none required any parenteral opioid or acute pain service intervention postoperatively. Parental satisfaction level was high (&gt;90%) with oral analgesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It is feasible that children with uncomplicated appendicitis given intraoperative <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content> can be successfully managed without <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12964","type":"journal-article","created":{"date-parts":[[2016,7,4]],"date-time":"2016-07-04T05:43:01Z","timestamp":1467610981000},"page":"1002-1009","source":"Crossref","is-referenced-by-count":9,"title":["An audit of patient\u2010controlled analgesia after appendicectomy in children"],"prefix":"10.1111","volume":"26","author":[{"given":"Rowan","family":"Ousley","sequence":"first","affiliation":[{"name":"Department of Children's Anaesthesia Women's and Children's Hospital Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura L.","family":"Burgoyne","sequence":"additional","affiliation":[{"name":"Department of Children's Anaesthesia Women's and Children's Hospital Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola R.","family":"Crowley","sequence":"additional","affiliation":[{"name":"Department of Children's Anaesthesia Women's and Children's Hospital Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Warwick J.","family":"Teague","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery The Royal Children's Hospital Melbourne Vic. 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