Pain, Analgesic Use, and Morbidity in Appendectomy Patients

Abstract

Pain has immunosuppressive effects among the critically and chronically ill, and opioids may immunomodulate pain's deleterious effects. However, little is known about the relations between acute pain, acute illness, and morbidity among previously healthy surgical patients. This study retrospectively examined these relations in appendectomy patients (N = 61). Eleven patients (18%) had morbidity, with atelectasis (11.5%) the most frequent complication. There were no differences between those patients with and without morbidity and pain intensity, method of opioid administration, and total opioid dose. Patients who received nonopioid analgesics received fewer opioids, less preemptive analgesia, and had less morbidity, whereas patients whose appendixes perforated received higher opioid doses and received more preemptive analgesia. Although the relations between acute pain, opioid use, and morbidity among previously healthy surgical patients are unclear, findings infer that clinical practice does not follow guidelines advocated by analgesic experts.

The Effect of Local Tramadol Injection in Post Appendectomy Pain

“…The use of systemic opioids alone is not enough for postoperative analgesic effect. It can be associated with side effects such as nausea, vomiting, constipation, itching, and respiratory and cardiac suppression [6,7]. In addition, non-steroidal antiinflammatory drugs (NSAIDs) may cause skin reaction, and renal (analgesic nephropathy) and digestive (peptic ulcers and their effects) complications.…”

Comparative Assessment of the Analgesic Efficacy of Tramadol and Diclofenac Sodium Rectal Suppository in Subjects Undergoing Laproscopic Tubal Ligation

“…[2,3] The nonopioid component is mediated through alfa-2 agonist and serotonergic activity, which it exerts by inhibiting the reuptake of norepinephrine and 5-hydroxytryptamine in the central nervous system and possibly by displacing the stored 5-HT from the nerve endings. [4][5][6][7][8] Tramadol is well tolerated by patients. Compared to morphine, tramadol has much less respiratory depression, cardiac depression, light headedness and sedative effect.…”