Laparoscopically Guided Rectus Sheath Block in Pediatric Appendicitis
Appendicitis Acute
About this trial
This is an interventional treatment trial for Appendicitis Acute
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of acute uncomplicated appendicitis
- Age 8-17 years
Exclusion Criteria:
- Complicated appendicitis, perforation, abscess
- History of chronic pain condition or long-term analgesic use
- History of bleeding condition
- Condition preventing accurate documentation of post-operative pain scores using the FPS-R tool including severe developmental delay, psychiatric illness, or partially sighted or blindness
- Previous open abdominal surgery
- Presence of an abdominal prosthesis such as a gastrostomy tube or ventricular-peritoneal shunt device
- Allergy to bupivacaine or morphine
Sites / Locations
- Stollery Children's HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Rectus Sheath Block
Local Anesthetic
Participants randomized to the experimental arm will receive a bilateral rectus sheath block which is additional to the standard of care (infiltration of 5mg (2mL) 0.25% bupivacaine with epinephrine around port site incisions). For rectus sheath block, use the formula Volume (ml) = 2mg/kg x weight (kg) divided by 2.5mg/ml - 6ml to a maximum of 14ml. Maximum total dose is 2mg/kg. Participants will be asked to rate their pain a total of 4 times for the study. Each occurrence is expected to take approximately 1-2 minutes to complete. There will be no additional follow-up required as part of the study. The 6 week follow-up visit is standard routine practice.
Participants in the control arm will receive the standard care which is infiltration of 5mg (2mL) of 0.25% bupivacaine with epinephrine around port site incisions. Participants will be asked to rate their pain a total of 4 times for the study. Each occurrence is expected to take approximately 1-2 minutes to complete. There will be no additional follow-up required as part of the study. The 6 week follow-up visit is standard routine practice.