Treatment of Appendicitis Before Surgery

Treatment of appendicitis is mostly surgical, although in recent years conservative medical management is also done, especially if appendicitis is in early stage and not very severe and risk of rupture of appendix is low. Use of appropriate antibiotics for one week to ten days can be successfully used. Many doctors prefer the surgical option for treatment of appendicitis, as there is risk of rupture of inflamed appendix and peritonitis as a result, which have high mortality rate.

Preoperative treatment of appendicitis:

Treatment of patient before surgery or preoperative management starts by not allowing the patient to eat or drink anything orally (nil orally). Intravenous drip is set up to keep patient hydrated (as patient is not allowed to drink orally) and appropriate antibiotics (commonly used antibiotics are metronidazole and cefuroxime) administered intravenously. Administration of antibiotics is required to keep infection under control and prevent spread of infection and also to reduce post operative complications.

Once the decision of surgery (appendisectomy) is made, the surgeon may explain to the patient or any family member about the surgical procedure, such as duration of surgery, recovery time after surgery, the risk of complications etc. Medications for vomiting should be started before starting surgery, as most patients may have nausea and vomiting after surgery. Pain medication should also be given to reduce pain after surgery is performed during recovery period.

If stomach is empty and there is no food residue present in stomach for at least 6 hours, general anesthesia is preferred for surgery and if emergency surgery is required or there is presence of food in the stomach, spinal anesthesia is preferred for appendisectomy operation.

Control of pain in appendicitis:

Pain of appendicitis can be very severe, in fact it is the most painful condition an individual may experience (more painful than heart attacks). Strong pain medications are required for control of pain before performing surgery and for this morphine like strong medications are recommended. But in many hospitals morphine is not available (because it is a drug for addiction). In case of unavailability of morphine, the drugs which can be used are pentazocin etc.

 

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