Evaluating Pain Management Strategies for Appendectomy: A Quasi-Experimental Study of Preincisional and Postoperative Bupivacaine Injection

Abstract

Objective: This study evaluated the effectiveness of preincisional and postoperative bupivacaine injections in reducing pain after appendectomy. Methods: This quasi-experimental study included 60 acute appendicitis patients undergoing appendectomy at Vajira Hospital. Participants were randomly assigned to three groups: group 1 received a preincisional 10-mL injection of 1% bupivacaine, group 2 received a postoperative 10-mL injection of 1% bupivacaine, and group 3 (control) received no bupivacaine. Postoperative pain was assessed using the Visual Analog Scale at 2, 6, 12, and 24-hour post-surgery. Complications, including wound hematoma and surgical site infections, were recorded Results: Pain scores were lower in both preincisional and postoperative bupivacaine groups compared to the control across all time points, with group 1 showing the greatest reduction. However, the differences in pain scores were not statistically significant. No complications, such as wound hematoma or surgical site infections, were observed, indicating bupivacaine's safety. Conclusions: Preincisional and postoperative bupivacaine injections are effective and safe for reducing pain after appendectomy. Preincisional administration shows the best pain reduction and is a practical pain management option, especially in resource-limited settings.