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>Journals >Cirujano General >Year 2009, Issue 2


Velázquez MJD, Ramírez SF, Vega MAJ
Premedication, delay factor in the diagnosis and surgical treatment of acute appendicitis
Cir Gen 2009; 31 (2)

Language: Español
References: 18
Page: 105-109
PDF: 4. Kb.


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ABSTRACT

Objective: To determine if pre-medication is a delay factor for the diagnosis and surgical treatment of patients with acute appendicitis.
Setting: Second level health care hospital.
Design: Prospective, comparative, longitudinal, and observational.
Statistical analysis: Parametric tests, Chi Squire and Student t test for the analysis of variables.
Material and methods: The study was performed in the Regional PEMEX Hospital in Salamanca, state of Guanajuato, Mexico, from January 1, 2006 to July 31, 2007. We analyzed the patients that sought medical care at the Emergency Service and coursed with clinical signs suggestive of acute appendicitis, of either sex, older than 5 years, with or without previous medication.
Results: We studied 56 patients, 32 (57.1%) men and 24 (42.9%) women. Mean age was 29.44 ± 17.65 years, range of 5 to 72. Appendectomy was performed in all patients, and the acute appendicitis diagnosis was confirmed with the histopathological result. Patients were divided in two groups, 23 (41.1%) in the non-medicated group and 33 (58.9%) in the medicated group; no statistically significant difference existed in terms of age and gender in the two studied groups (p ‹ 0.05). The mean of hours elapsed between the start of symptoms and the decision to perform surgery was significantly lower in the non-medicated group than in the medicated group (23 hours, IC95% 16-23 vs 33 hours, IC95% 30-54; t = 3.9, p = 0.0001). Hospital stay days of non-medicated patients were of 2.3 ± 1.6 vs 3 ± 1.3 days for the medicated ones, without significant difference (t = 1.2 y p = 0.22); however, there was a statistically significant difference in regard to the days of sick leave for the patients that received previous medication.
Conclusion: Previous medication with analgesics and antibiotics in patients with acute appendicitis is, indeed, associated with a delay in taking the surgical decision, with an increment in complications, such as appendicular perforation, increase in the days of hospital stay and of sick leave.


Key words: Premedication, acute appendicitis, appendectomy.


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