Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Background: The safety of using early analgesia in patients with suspected acute appendicitis is still controversial. METHODS: randomized controlled trial comparing patients receiving with those not receiving NSAIDS at an early stage of acute appendicitis (AA). Primary aim was looking for any clouding effect of analgesic administration on the accuracy of clinical evaluation, the later part of the study looked for development of complications, change of the rate of negative appendectomy or the hospital stay. results: This work focused on clinical and therapeutic outcome, hence the ability to guarantee safe practice. Non-steroidal anti-inflammatory drug (NASIDS) administration did not affect rigidity (p=1.000) or rebound tenderness (p=0.250) while other signs became less clear. NASIDS administration did not have an impact on hospital stay (p=0.724). Safety was not compromised by NASIDS, as the difference in complication rates did not reach statistical significance (P > 0.05). conclusion: Early analgesia with NASIDS in suspected AA might influence some clinical signs but not the important ones. Therefore this practice does not appear to alter diagnostic accuracy or surgical outcome. To support our findings, further trials on larger sample sizes from different age groups and both genders are needed

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