Narcotic vs. Non-narcotic Pain Regimens After Pediatric Appendectomy

There is concern that pain prescription after outpatient pediatric surgical procedures is
excessive and is in excess of patient need. Current practice following pediatric appendectomy
is to prescribe all children with 5-15 doses of narcotic pain medication upon discharge
regardless of their age, severity of appendicitis, or pain control in the hospital. This
study examines the amount of narcotic pain control required by pediatric patients after
undergoing appendectomy using a randomized controlled trial study design.

Children admitted after undergoing surgical management for a diagnosis of acute appendicitis
will be randomized at discharge to a narcotic arm or a tylenol/motrin arm. The narcotic arm
will receive the standard of care narcotic prescription. The tylenol/motrin arm will receive
education to use tylenol and motrin for pain control as well as a paper prescription provided
for the sole purpose of rescue.

Pain control will be assessed with a post-operative pain scale, patient satisfaction survey,
and parent satisfaction survey on the days following surgery and at post-operative follow-up.

The hypothesis is that the pain scores and patient satisfaction surveys will show no
difference in post-operative pain control between the two arms.