A Study of Comparison of Post-operative Pain in Open and Laparoscopic Appendectomy

Abstract

Objectives: To compare post-operative pain, analgesic requirements, complications, hospital stay, and recovery outcomes between laparoscopic and open appendectomy.

Methodology: This prospective observational study was conducted in the Department of General Surgery, Islamabad Medical Complex, NESCOM, from April to September 2024. A total of 60 patients with acute appendicitis were enrolled, with 30 each undergoing LA or OA. All patients during data collection period undergoing appendectomy were included in the study. Patients unfit for laparoscopic intervention as patients with cardiac or pulmonary disease, patients who were treated conservatively beyond 24 hours of admission and patients on chronic pain medication for any other issues were excluded.All patients received intravenous paracetamol (1 g thrice in 24 hours) and ketorolac tromethamine (30 mg twice in 24 hours). Post-operative pain was assessed using the Visual Analogue Scale (VAS) at 4 hours, 24 hours, and 14 days. Outcomes included analgesic use, hospital stay, return to normal activity, and complications. Data were analyzed using SPSS 25.0, with p ? 0.05 considered significant.

Results: LA patients had significantly lower pain scores at 4 hours (4.93 vs. 6.13, p=0.029) and 24 hours (3.20 vs. 4.40, p=0.021). Additional analgesic use was significantly less in LA (p=0.013). Hospital stay was similar, but return to normal activity was faster with LA (2.87 vs. 3.60 weeks, p<0.001). Wound infection was higher in OA (13.3% vs. 0%, p=0.038).

Conclusion: Laparoscopic appendectomy results in lower post-operative pain, fewer complications, and earlier recovery compared with open appendectomy, supporting LA as the preferred approach for acute appendicitis.