Comparison of Postoperative intravenous painkiller usage and Hospital length Between Early and Delayed Open Appendectomy

Abstract

The comparison of early appendectomy versus delayed appendectomy reveals no significant differences in overall postoperative complications. Nevertheless, variations in postoperative pain and recovery duration are observed across individual cases. The present study aims to compare the frequency of intravenous painkiller usage, and the length of postoperative hospitalization between patients undergoing appendectomy within eight hours versus those appendectomy after eight hours following hospital admission. The cross-sectional study included 486 total appendectomies at Pattani Hospital between July 2022 and July 2024.

Results showed, for cases of uncomplicated appendicitis, there was no difference in postoperative intravenous painkiller usage between appendectomies performed within 8 hours of hospital admission and those performed after 8 hours (0.8 and 0.8 times/case; p=0.907). However, for complicated appendicitis, appendectomies within 8 hours were significantly less postoperative intravenous painkiller usage compared to those performed after 8 hours (1.4 and 2.5 times/case; p=0.020). Meanwhile, the length of hospital stay after appendectomy were not different between early and delayed appendectomy for both uncomplicated and complicated appendicitis groups.

Conclusions: Performing an appendectomy for acute appendicitis beyond eight hours after hospital admission does not prolong the postoperative hospital stay. However, appendectomy within eight hours of the hospital arrival can reduce the need for postoperative analgesics. The decision to proceed with surgical intervention remains dependent on the patient’s informed consent, the time of the patient’s arrival, and the urgency of accessing emergency operating facilities outside regular working hours, all of which vary according to the specific context of each hospital.