Preoperative use of analgesia in appendicitis.
OBJECTIVE
To determine the influence of diclofenac sodium (DS) on masking the diagnosis of acute appendicitis.


METHODS
A prospective, experimental study was carried out in Ibn Sinna General Hospital, Mukalla, Hadramout Governorate, Yemen from November 2006 to March 2007. The data were collected using a well designed questionnaire, with observation during the period of admission, prior to the operation.


RESULTS
This study includes 80 patients (40 as cases, and 40 as controls), and the results revealed that most of the symptoms (fever, anorexia, nausea, and vomiting), and signs (tenderness, obturator and psoas signs, local guarding, and rigidity), were not hidden by DS (p>0.05), while other symptoms (pain), and signs (rebound tenderness, Rovsing's, and pointing) had been hindered by the use of DS. The most common presenting symptom in the placebo and DS group was pain (100%), which showed a marked decrease in severity in those who received DS as analgesia (72.2%).


CONCLUSIONS
Some of the symptoms, and signs of acute appendicitis were masked by the use of analgesia, while others were not. In summary, DS did not influence the diagnosis or management of acute appendicitis.
Aram
Fahmi O
FO
Department of Surgery, College of Medicine, Hadramout University, PO Box 50595, Mukalla, Hadramout, Yemen. fahmiooa@hotmail.com
D015746:Abdominal Pain / Q000175:diagnosis; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D001064:Appendicitis / Q000175:diagnosis* / Q000503:physiopathology; D004008:Diclofenac / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac